World Health Organization - International Society of Hypertension Guidelines and the role of ongoing trials

Guidelines for non-pharmacological and pharmacological approaches to the treatment of hypertension were issued for the first time in the middle of the 1970s and were periodically updated in the following years. This paper will review the main features and elements of novelty of the World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension issued in 1999. After briefly describing data relating to the epidemiology of hypertension, the 1999 WHO-ISM Guidelines take into account the determinants of cardiovascular disease risk in hypertensive patients. Particular emphasis is placed on the contributions from and interactions between high blood pressure and other factors or conditions (diabetes, smoking, hypercholesterolaemia, alcohol consumption, overweight and obesity, etc) involved in determining the risk profile of individual patients. Finally, the WHO-ISM 1999 Guidelines provide recommendations for hypertension drug treatment in relation to the risk stratification and prognosis quantification, indicating the specific therapeutic strategy to be followed in each risk category.