Preventing vascular events due to elevated blood pressure.

Elevated blood pressure (BP) demonstrates a consistent, strong, and graded relationship across the entire spectrum at levels 110 mm Hg systolic with several cardiovascular disease outcomes including cardiovascular death, myocardial infarction (MI), stroke, heart failure, and renal dysfunction.1 The population attributable risk due to elevated BP is large and consistent in all ethnic groups and regions of the world.2,3 In many countries (eg, United States, Canada, and Japan), strokes (especially hemorrhagic strokes) have been declining, which can be attributed, to a significant extent, to better BP control, although other factors (eg, changing diets and social and economic circumstances) are also likely to be important.4 By contrast, over the last 2 or 3 decades, the prevalence of heart failure has been increasing5 despite the increase in the proportion of patients with hypertension receiving BP-lowering therapy. This overall picture masks a decrease in heart failure in younger individuals, which is more than counterbalanced by an increase in the elderly.5