The talk about the early use of drugs for essential hypertension

The public statement in guidelines used to be (use non-pharmcologic measures for six months before deciding on medication). Some authorities are questioning this point. I'm with this and I want to make a simple reasoning for early pharmacologic therapy.

To start with, know that Essential hypertesion have a cause whether the exact mechanism is known or not and I think the term essential would favor keeping it unknown.

Whatever the cause may be, if the BP stayed high for a while it may soon produce a damage in some part of the arterial system. This would result in subclinical ischemic changes somewhere, not necessarily the kidneys. Autoregulation would automatically lead to an increase in the BP in order to normalize the blood flow to this as yet still unknown arterial bed. Now we have already two causes for the hypertension. If the BP stayed high for a while further a third cause would eventually result. In ohter word a vicious circle would have been created.

So my opinion is to start pharmacologic treatment fully complying with guidelines side by side with a low salt DASH diet and always check and keep serum uric acid below 5.5mg/dl.

In Egypt there is a misbelief among patients that we should all fight to change, that is "if I started taking medicine for hypertension I will take it for life, so I will not take it. I will wait until I'm sure the doctor have right" By so doing the doctor will certainly have right.

I'm sure that if we treated essential hypertension early with drugs doctors may not have right. I have seen in many cases the hypertension cured.