Initial Therapy for Hypertension—Individualizing Care

Of the approximately 58 million Americans with hypertension, the majority have only mild increases in blood pressure and individually are at low risk. Large group studies, however, have demonstrated the efficacy of treating mild hypertension. Public health efforts during the past 16 years have increased the number of hypertensive patients made aware of their condition and brought into treatment. A major problem, however, is consistently maintaining patients on long-term therapy. A large number of nonpharmacologic and pharmacologic treatments have become available for the management of hypertension. These treatments must be applied individually to enhance benefit, minimize potential harm, and increase the likelihood of long-term compliance for what is often a lifelong disorder. For accomplishing this goal, a thorough understanding of important characteristics of both the individual patient and the available therapeutic modalities is needed.