Predicted reductions in the risk of coronary heart disease by antihypertensive therapy: the confounding effect of lipids

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The treatment of arterial hypertension confers several important benefits, e.g. reducing hypertension-induced cardiovascular morbidity and mortality. However, the preventive effect for coronary heart disease is considerably smaller than the effect of treatment on the incidence of strokes. Several factors may explain this discrepancy, but it appears likely that drug-induced increases in serum lipoproteins may, to some extent, offset the risk reduction obtained through the lowering of blood pressureIt appears that more emphasis should be put on therapeutic intervention in other risk factors in addition to the treatment of hypertensionAn appropriate therapeutic aim of the treatment of hypertension should be to lower blood pressure to 'normotensive' levels, by using drugs which do not themselves increase cardiovascular risks, e.g. do not increase serum lipoproteins, and to actively intervene against other co-existing risk factors, such as hyperlipidaemia. By using this approach, it seems likely that the risk of coronary heart disease can be reduced

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