Case Presentations

To fully appreciate the complexity and challenges in interpreting hypertension trials, it is informative to review their evolution. The prospective, randomized, clinical trial has been the foundation for evaluating the effectiveness of blood pressure-lowering drugs. The duration of clinical trials rarely exceeds five years, and trials focus on so-called “hard end points”—notably, all-cause mortality and/or cause specific morbidity and mortality due to CVD, usually coronary heart disease (CHD) and/or stroke, but more recently heart failure (HF) as well.

The early clinical trials had the advantage of being able to compare active therapywith placebo and usually included patients with more severe hypertension, as compared with modern trials. Consequently, they generated more end points and had sufficient power to be conducted on a smaller scale than modern trials high blood pressure is often called a "silent disease" because people usually don't know they have it; there may be no outward symptoms or a sign, so monitoring the blood pressure is critical. Treating high blood pressure can take a multi-pronged approach including diet changes, medication, and exercise. Hypertension treatment comes in many forms -- from lifestyle changes to medication.

  • Integrating lifestyle advice into clinical management
  • Meta-analysis of blood pressure-lowering drug trials
  • Reporting blood pressure parameters in clinical trails
  • Surrogate or intermediate disease markers
  • Primary biliary cirrhosis

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