Hypertension in the 1990s: a new disease.

BACKGROUND Recent analyses of the cumulative results of the major treatment trials of mild-to-moderate hypertension have shown only a small benefit in the prevention of stroke and no benefit in the prevention of coronary heart disease. METHODS A MEDLINE search for articles published from 1966 to 1991 was made using the key words "left ventricular hypertrophy," "hypertension," "insulin resistance," and "cholesterol." The bibliographies of these articles and articles previously abstracted in The Family Practice Newsletter (InforMed) and the author's personal files were also sources of information. RESULTS AND CONCLUSIONS Newer pharmacologic agents for hypertension, the peripheral alpha-blockers, the calcium channel blockers, and angiotensin converting enzyme inhibitors, exert positive effects on left ventricular hypertrophy, serum lipids, and serum insulin and could be cardioprotective. These drugs offer the promise of being able to show cardiovascular benefits from the treatment of mild-to-moderate hypertension that were not realized in the earlier clinical trials.