The Clinical Significance of Blood Pressure Lowering Treatment: Is First-Line Drug Choice Important?The Contrary Position

According to the recommendations of the European Society of Hypertension/European Society of Cardiology guidelines on the diagnosis and management of hypertension, the major benefits of antihypertensive treatment are related to blood pressure reduction per se rather than to the specific drugs used. This article reviews this statement by discussing the evidence provided by a number of clinical trials that blood pressure reduction is more important than the antihypertensive drug choice in uncomplicated hypertensive patients. The difference between drugs will become increasingly important as the cardiovascular risk profile of the patient becomes elevated and/or when associated risk factors or concomitant target organ damage are detected.