Hypertension control and cardiovascular disease

In the Viewpoint by Jacques Blacher and colleagues (July 30, p 530), 1 decreased population prevalence of cardiovascular disease and associated increased life expectancy in some high-income countries in recent decades were attributed to improvements in screening and treatment. Focusing on elevated blood pressure as a risk factor, Blacher and colleagues proposed new strategies for managing hypertension, emphasising pharmacological interventions involving antihypertensive drugs and drug combinations directed at ambitious blood pressure targets in the initial stages of diagnosis and thereafter throughout life. Without dismissing potential benefit to patients, the proposed strategies are obviously not sufficient to achieve the population-level epidemiological transition in cardiovascular disease that Blacher and colleagues evidently see as the overarching goal.