Hypertension 2005: An evidence-based approach to diagnosis and treatment - An American perspective

Robert A. Phillips, Joy M. Weinberg

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Midway into the first decade of the 21st century, evidence-based medicine has come the predominant methodology for the education and practice of medicine. In the ascent to this pre-eminent position, evidence-based medicine has challenged several methodologies through which medicine was taught and practiced throughout the 20th century, including the clinical anecdote, the concept that medicine is an art, the notion that the physician acts as the filter through which medical knowledge is individualized for the patient, and to some extent, the application of principles of pathophysiology to guide individual patient care. Indeed, it appears that in many cases, this mechanism-based approach to disease has been replaced by a broad strokes population-based approach based on outcomes research. However, as in the law, evidence is open to interpretation, varying opinion and nuance. Perhaps nowhere is this more evident than in the field of hypertension, which arguably can be credited with developing the field of evidence-based medicine with randomized clinical trials in the early 1960s and early adaptation and promotion of outcomes-based research, beginning with the first Joint National Committee report on prevention, detection, evaluation and treatment of high blood pressure in the 1970s. The purpose of this chapter is to review the evidence in the diagnosis and treatment of essential hypertension, focusing on the following areas. First, use of ambulatory and home blood pressure monitoring as diagnostic and prognostic tools; second, recent clinical trials in the treatment of essential hypertension that form the basis of evidence-based therapeutics; and third, presentation of the key features of the Joint National Committee (JNC) 7, which forms the current basis of treatment for essential hypertension.

Original languageEnglish (US)
Pages (from-to)691-704
Number of pages14
JournalExpert Review of Cardiovascular Therapy
Volume3
Issue number4
DOIs
StatePublished - Jul 2005
Externally publishedYes

Fingerprint

Evidence-Based Medicine
Hypertension
Ambulatory Blood Pressure Monitoring
Medicine
Outcome Assessment (Health Care)
Anecdotes
Therapeutics
Art
Patient Care
Randomized Controlled Trials
Clinical Trials
Physicians
Education
Population
Essential Hypertension

Keywords

  • Ambulatory blood pressure monitoring
  • Compelling indications
  • Coronary artery disease
  • Diabetes
  • Hypertension
  • Hypertensive nephrosclerosis
  • Masked hypertension
  • Octogenarians
  • Organ damage
  • Prehypertension
  • Risk stratification
  • Target
  • Uncomplicated hypertensio

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hypertension 2005 : An evidence-based approach to diagnosis and treatment - An American perspective. / Phillips, Robert A.; Weinberg, Joy M.

In: Expert Review of Cardiovascular Therapy, Vol. 3, No. 4, 07.2005, p. 691-704.

Research output: Contribution to journalArticle

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