Wars, War Games, and Dead Bodies on the Battlefield Variations on the Theme of Blood Pressure Variability

Abstract

Antihypertensive treatment is accepted as the most effec-tive means for preventing stroke, and its effectiveness is solidly founded on a series of large randomized controlled trials.1,2 Hypertension experts can be proud that antihyperten-sive therapy has been the first among cardiovascular therapies that has been tested by randomized controlled trials using so-called hard end points (ie, fatal and nonfatal stroke, fatal and nonfatal myocardial infarction, cardiovascular death, and death by any cause), all verified by independent blind clinical event committees.3 Trials are intended to be examples of treatment in everyday life, and hard end point trials measure and compare results (or outcomes) of different interventions by simply counting dead bodies or wounded bodies on the battlefield. This is what is rightly considered solid evidence. Although trials generally cannot explore mechanisms, unavoidably (and, up to a give