Antonín vancura and arterial hypertension. 50 years' evolution in the conception of pathogenesis and treatment of the disease.

A historical overview of the important contributions of Prof. Antonin Vancura from Charles University Medical Faculty, Prague, to the broader understanding of the pathogenesis, clinical course and classification of arterial hypertension is given in his pivotal publication and first Czech monography 'High Blood Pressure'. His unique clinical series of 1,096 hypertensive patients with their long-term follow-up after 5, 10 and 15 years made it possible to work out the classification of hypertension not only on the basis of blood pressure readings, but also according to target organ damage--a principle which is close to the 2003 classification of the European Society of Hypertension/European Society of Cardiology (ESH/ESC). In agreement with today's conception, Vancura emphasized already in 1942 the importance of metabolic changes and albuminuria for prognosis of the disease. In spite of the technical, instrumental and laboratory limitations, it is possible to gain from Vancura's publication a modern interpretation of his results given by a long-term follow-up of this large group of patients. In many ways, Vancura outstripped his time and his concepts approached today's standings and so founded one of the important schools of hypertension in Czechoslovakia and Europe.