The Year in Hypertension Bryan Williams, MD, FRCP, FAHA Leicester, United Kingdom

This review focuses on published works in 2005, up to April 2006, that have implications for clinical practice in the clinical management of hypertension. It has been an eventful year with a number of key publications. We have gained new insights into the epidemiology of hypertension and better characterization of the “hypertensive phenotype” that poses challenging questions about when and how to begin treatment in people at risk of developing hypertension.

We have also begun to gain a better understanding of the clinical significance of atrial fibrillation in people with hypertension and of the treatment strategies for its prevention. Further studies have yielded important new information about the differential impact of blood pressure (BP)-lowering drugs on central aortic pressure and its potential role in clinical outcomes.

These studies have complemented new data from major clinical outcomes trials that have served to consolidate the evidence base for some aspects of existing hypertension treatment guidance but also have questioned the role of beta-blockade as a routine treatment for hypertension. This has been an invigorating year of discovery that has begun to shift the foundations that have previously provided a stable platform for current thinking. There seems little doubt that these new data will be the catalyst for new ideas and ultimately a reappraisal and revision of hypertension treatment guidelines in the year to come.

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