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Essential hypertension
Messerli FH, Williams B, Ritz E.. Lancet (London, England), 2007-08-01
Topic: Risk, prevention and care in population studies
Essential hypertension can be defined as a rise in blood pressure of unknown cause that increases risk for cerebral, cardiac, and renal events. In industrialised countries, the risk of becoming hypertensive (blood pressure >140/90 mm Hg) during a lifetime exceeds 90%. Essential hypertension usually clusters with other cardiovascular risk factors such as ageing, being overweight, insulin resistance, diabetes, and hyperlipidaemia. Subtle target-organ damage such as left-ventricular hypertrophy, microalbuminuria, and cognitive dysfunction takes place early in the course of hypertensive cardiovascular disease, although catastrophic events such as stroke, heart attack, renal failure, and dementia usually happen after long periods of uncontrolled hypertension only. All antihypertensive drugs lower blood pressure (by definition) and this decline is the best determinant of cardiovascular risk reduction. However, differences between drugs exist with respect to reduction of target-organ disease and prevention of major cardiovascular events. Most hypertensive patients need two or more drugs for blood-pressure control and concomitant statin treatment for risk factor reduction. Despite the availability of effective and safe antihypertensive drugs, hypertension and its concomitant risk factors remain uncontrolled in most patients.
Key findings
- Subtle target-organ damage such as left-ventricular hypertrophy, microalbuminuria, and cognitive dysfunction takes place early in the course of hypertensive cardiovascular disease, although catastrophic events such as stroke, heart attack, renal failure, and dementia usually happen after long periods of uncontrolled hypertension only.
- All antihypertensive drugs lower blood pressure (by definition) and this decline is the best determinant of cardiovascular risk reduction.
- However, differences between drugs exist with respect to reduction of target-organ disease and prevention of major cardiovascular events.
- Most hypertensive patients need two or more drugs for blood-pressure control and concomitant statin treatment for risk factor reduction.
- Despite the availability of effective and safe antihypertensive drugs, hypertension and its concomitant risk factors remain uncontrolled in most patients.
Why it matters
This review states that dementia usually happens only after long periods of uncontrolled hypertension, and that all antihypertensive drugs lower blood pressure, which is the best determinant of cardiovascular risk reduction. It reports no direct evidence that blood pressure treatment prevents or cures Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 55/100
Published in a top-tier journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Lancet (London, England)) |
| Journal's citation record | 4 / 4 | The Lancet: journal h-index 1,205 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2007 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 682 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 32.5 citations a year over 21 year(s) since 2007 |
| Impact for its field and year | 5 / 6 | Cited 22.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 3 / 4 | Cited 150 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Eberhard Ritz: h-index 114 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17707755) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Messerli, F. H., Williams, B., & Ritz, E. (2007). Essential hypertension. Lancet (London, England). https://doi.org/10.1016/s0140-6736(07)61299-9
Vancouver
Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet (London, England). 2007. doi:10.1016/s0140-6736(07)61299-9. PMID: 17707755.
BibTeX
@article{messerli2007-17707755,
author = {Messerli, F. H. and Williams, B. and Ritz, E.},
title = {{Essential hypertension}},
journal = {Lancet (London, England)},
year = {2007},
doi = {10.1016/s0140-6736(07)61299-9},
pmid = {17707755},
url = {https://doi.org/10.1016/s0140-6736(07)61299-9}
}
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