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Vasc Health Risk Manag. 2005;1(3):257-60.

Blood pressure and control of cardiovascular risk.

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  • 1John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia.


Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving away from a dichotomous approach to risk classification, and away from notions of hypertension and normotension towards an appreciation that blood pressure-related risk is continuous. In parallel, there has been a paradigm shift from a single risk factor approach to comprehensive cardiovascular disease risk prevention. Accordingly, prevention of cardiovascular disease requires a focus on lowering of blood pressure and modification of associated risk factors rather than simply treatment of hypertension. This emphasis is reflected in the World Health Organization (WHO)-International Society of Hypertension (ISH) 2003 statement on management of hypertension.

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