Importance of Rapid and Effective Reduction of Blood Pressure in Treating Hypertension for the Prevention of Cardiovascular DiseasesA Lesson from the VALUE Study

The efficacy of antihypertensive medications in reducing the high blood pressure (BP) levels in patients with hypertension has been demonstrated, but the incidence of cardiovascular diseases in treated hypertensive subjects is still higher compared with subjects with normal BP values. This discrepancy could chiefly stem from: (a) the inability of the pharmacological treatment to normalise BP levels in all treated patients; (b) poor pre-evaluation of cerebral, cardiac and renal damage involvement in treated patients; and (c) the inappropriate choice of antihypertensive drug. If we consider that the recent guidelines on the treatment of hypertension have further reduced the thresholds of normal BP values (e.g. 120–129mm Hg for systolic and 80–84mm Hg for diastolic BP), we can hypothesise that in Italy today optimal control of BP in patients with hypertension could be further reduced, when compared with the past, and could be estimated to be obtained at present in only 25% of treated patients. This situation is of course unacceptable and efforts should be made by educational institutions to recommend that physicians apply current recommendations from the guidelines, aiming at properly normalising BP in treated hypertensive patients.