ABSTRACT
The prevention of premature death from cardiovascular disease is built upon basic, clinical, and epidemiological research. Some of the most important advances are in the identification and treatment of high blood pressure. Epidemiological studies have shown that high blood pressure is a risk factor for early death. Basic science has identified some of the mechanisms that regulate blood pressure and pharmacological science has advanced products that lower blood pressure (Hollenberg, 1995, Kaplan et al., 1995, Krakoff, 1995, Laraght & Brenner, 1995). Clinical trials have provided evidence that lowering blood pressure produces health benefit (Hypertension Detection and Follow-up Program, 1979, SHEP, 1991). However, these results may not apply to all people. Epidemiological associations observed in some populations may not generalize to all populations. Further, interventions that benefit most people, may not help selected subgroups. Health educators are often asked to promote medical prevention programs. The purpose of this paper is to challenge the notion that recommendations for the general population are uniformly appropriate for our oldest citizens.
