Hypertension, Arterial Mechanics and Other Issues

Ricardo Esper

Abstract


Hypertension alters arterial wall function. The application of knowledge of the principles of arterial mechanics allows making more adequate diagnoses with better indications about how to treat patients. The development of large clinical and treatment trials produced the so-called evidence based medicine. These studies have represented a significant advance in the knowledge of the natural history of diseases and allowed establishing the best therapeutic options. However, the patient seeking medical advice has personal, geographical, cultural and emotional conditions that, in most cases, differ from those of the patients selected in the trials, and require a variant of the therapeutic approaches used in those trials. Treatment guidelines were designed on the basis of the results of evidence based medicine and are useful to reduce mistakes made by those who are not experts in the topic. The specialist should consider the particular patient he/she is facing using the knowledge provided not only by evidence based medicine but also by his/her personal experience and other ways of evaluation. In this way, the specialist can justify why he/she does not follow the recommendations suggested by the guidelines for his/her patient’s benefit. Briefly, this would mean moving from

only  evidence-based medicine to personalized evidence-based medicine.

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