Blood pressure and long-term coronary heart disease mortality in the Seven Countries Study: implications for clinical practice and public health

To prevent high blood pressure in a public health context, blood pressure-reducing interventions should be selected based on their potential to reduce the incidence of coronary heart disease in the population as a whole. In public health, the population attributable risk is a widely used measure of risk. This population attributable risk is the proportion of all diseased individuals attributable to hypertension. Population attributable risk not only depends on the relative risk, but also on the proportion of the total population that is exposed, i.e. on the prevalence of hypertension. Epidemiological measures of risk can thus be used as a basis for developing effective strategies for prevention of blood-pressure-related diseases, both in clinical medicine and public health. This hotline editorial deals with such an application of these risk measures, in view of the results of a recently published study on blood pressure and mortality from coronary heart disease in the Seven Countries Study. The study and its main findings are described and the implications for treatment and prevention of hypertension in relation to coronary heart disease are discussed.