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Short- and long-term perspectives of antihypertensive therapy. An introduction.

Randomized trials of antihypertensive therapy are relatively short in duration (3 to 5 years) and, when based on monitoring of the mortal and morbid events occurring during this period of time, represent short-term perspectives of antihypertensive therapy. In cases of mild-to-moderate hypertension, however, the goal of antihypertensive therapy is not the prevention of impending events but, rather, the avoidance or retardation of cardiovascular lesions. These long-term perspectives can only be explored by randomized trials that monitor surrogate endpoints (for example, left ventricular hypertrophy or atherosclerotic plaque development). In the future, more and more antihypertensive drugs will be tested to assess their ability to interfere with both cardiovascular disease and cardiovascular events.