ReviewHypertension: which aspects of hypertension should we impact on and how?Zanchetti, Albertoa; Waeber, BernardbAuthor Information aCentro di Fisiologia Clinica e Ipertensione, Università di Milano, Istituto Auxologico Italiano, Ospedale Maggiore, Milan, Italy bDivision d'Hypertension et de Maladies Vasculaires, Lausanne, Switzerland Correspondence and requests for reprints to Professor Alberto Zanchetti, Centro di Fisiologia Clinica e Ipertensione, via F. Sforza 35, 20122 Milano, Italy E-mail: email@example.com Journal of Hypertension: August 2006 - Volume 24 - Issue - p S2-S5 doi: 10.1097/01.hjh.0000240039.97472.f1 Buy Metrics Abstract Cardiovascular complications may, to a large extent, be prevented by lowering blood pressure in hypertensive patients. International recommendations currently stress the importance of reaching values of below 140/90 mmHg in each patient or even lower in the case of concomitant diabetes or renal impairment. It is currently considered crucial to control the systolic pressure as well as the diastolic pressure, in particular because the relationship between cardiovascular risk and blood pressure is closer for the systolic than the diastolic value. An increase in systolic pressure is in itself a sign of the stiffening of the arterial tree. In most patients, the target pressure may only be reached by combining several different antihypertensive agents. In the STRATHE Study, a greater antihypertensive efficacy, in particular on systolic pressure, was obtained by instituting treatment with a fixed low-dose combination of an angiotensin-converting enzyme inhibitor (perindopril) and a diuretic (indapamide), in comparison with other therapeutic strategies based on single-agent therapy. Fixed-dose antihypertensive combinations have now become a validated option for initiating antihypertensive treatment. © 2006 Lippincott Williams & Wilkins, Inc.