HYPERTENSION

I have a fairly radical view of hypertension, which is that as a risk factor we have been not able to treat it effectively. As a result, patients continue to die while taking expensive medications. I question the viability of blood pressure as a diagnosis in older patients. I base these radical statements in part on the following:

"Lowering blood pressure or treating hypertension with a variety of antihypertensive agents reduced stroke; No effect was seen on vascular or all-cause mortality" (Stroke 2003 Nov;34(11):2741-8)

Patients experienced fewer strokes but died at the same rate.

"In spite of its importance in causing cardiovascular disease blood pressure is a poor predictor of cardiovascular events; persons in the top 10% of the distribution of systolic blood pressure experienced only 21% of all ischaemic heart disease events and 28% of all strokes at a given age.. the term hypertension should be avoided because it is not a disease and it implies another category (normotensives) who would not benefit from lowering blood pressure (Health Technol Assess. 2003;7(31):1-94)

These experts recommend hypertension drugs for everyone, while I wonder about the whole idea that hypertension leads to stroke. It makes strokes worse, but are there other factors that are actually causing the stroke that we are not addressing?