In the absence of more extensive knowledge concerning the etiology of essential and malignant hypertension, current attempts at their management with drugs necessarily consist of symptomatic therapy. Such therapy is directed largely toward lowering the elevated blood pressure, either for short periods of time and on isolated occasions when a hypertensive crisis is present or imminent or on a more continuous schedule with day-to-day medication. The principles upon which such symptomatic treatment are based are (1) that reduction of the elevated pressure may reduce symptoms and cardiac work and may prevent retinal and cerebral hemorrhages; (2) that it may prevent or retard progressive arteriolar injury and thus intensification of the disease process.
The purpose of this pharmacological discussion is not to evaluate the concept of using hypotensive agents in the therapy of hypertension or to assess the therapeutic value of the procedure. Rather it is to outline briefly the known