American Heart Association High Blood Pressure Research

Cureus, 2018

Hypertension is the most prevalent clinical symptom arising from various cardiovascular disorders. Likewise, it is considered a precursor or sequelae to the development of acute coronary artery disease and congestive heath failure (CHF). Hypertension has been considered a cardinal criterion to determine cardiovascular function. According to the World Health Organization (WHO) global observatory data, hypertension causes more than 7.5 million deaths a year, about 12.8% of the total human mortality. Similarly, the Center for Disease Control (CDC) states that 35% of the American adults have been estimated to have a persistently high blood pressure, which makes it about one in every three adults. Hypertension is a modifiable symptom that can be managed through pharmacological and non-pharmacological methods and standard protocols set forth by the American Heart Association (AHA). With new findings from various clinical trials related to the management of hypertension, new developments a...

Hong Kong Medical Journal, 2020

American health & drug benefits, 2010

Hypertension is a significant and costly public health problem. It is a major, but modifiable contributor for the development of cardiovascular disease. Randomized controlled trials have shown that controlling hypertension reduces the risk of stroke, coronary artery disease, congestive heart failure, end-stage renal disease, peripheral vascular disease, as well as overall mortality. The risk of developing these hypertension-related complications is continuous, starting at a blood pressure level as low as 115/75 mm Hg. Despite the inherent health risks associated with uncontrolled hypertension, elevated blood pressure remains inadequately treated in the majority of patients. This article reviews guidelines for optimal evaluation of hypertension and current therapeutic options available to combat this common yet pervasive disease.

Current Hypertension Reports, 2019

Purpose of Review To provide an overview of the different guidelines for hypertension management from around the world. Recent Findings The guidelines discussed include those from the United States (US), Europe, Canada, and Latin America. All guidelines except the US define hypertension as > 140/90 mmHg, and the US defines it as > 130/80 mmHg. In general, all guidelines except those from the US emphasize lifestyle modification as the cornerstone of initial therapy given blood pressure levels < 140/90 mmHg. The US emphasizes lifestyle modification at all BP levels starting at 130/80 mmHg. Additionally, all guidelines emphasize the need to assess cardiovascular risk with the Canadian guidelines indicating that a high cardiovascular risk person should have a goal of < 130/80 mmHg. All agree on the proper method of blood pressure measurement techniques and importance of home blood pressure. All support use combination therapy with the European guideline emphasizing initial therapy should be a combination pill. All guidelines stress the importance of patient adherence to maintain blood pressure control. Summary All guidelines emphasize lifestyle modification, need for home blood pressure measurement, as well as use of proper techniques to measure blood pressure. The fundamental difference between US and all other guidelines is the definition of hypertension, > 130/80 mmHg in US and > 140/90 mmHg in the rest of the world.

Singapore Family Physicians, 2019

Management of hypertension will continue to evolve as new studies provide us more evidence on many relevant aspects of care for this very common condition. To define hypertension, we need to be able to measure blood pressure (BP) accurately and make it easily reproducible. The mercury sphygmomanometer has been a standard tool to measure BP, but it is evident that it will be phased out soon and replaced by electronic BP devices-both for clinic and home use. There is increasingly more awareness of the benefits of out-of-office (clinic) BP measurement to estimate extent of BP control and also prognosis. The goal for BP treatment has also evolved and, for the first time in decades, there has been a suggestion that a lower-than-140/90 mmHg target is associated with further reduction in adverse cardiovascular outcomes. There is, however, a need for more pills and an increased risk of treatment-related side effects. The choice of which anti-hypertensive to use, as well as the goal of treatment, should be individualised and discussed with the patient.

2018

In the United States, one-third of all adults have hypertension (HTN), and 35.8 million of those are uncontrolled. As a leading risk factor, high blood pressure (BP) is a predisposing factor for almost 80% of all cardiovascular chronic illnesses. The risk for major, debilitating cardiovascular disease (CVD) events (heart failure, myocardial infarction [MI], and stroke) drops significantly when BP reaches the guideline-based target (140 mm Hg systolic) or lower. Randomized controlled trials (RCTs) have found that lowering BP by as little as 10 mm Hg in patients with HTN can reduce a person&quot;s lifetime risk for cardiovascular and stroke death by 25% to 40%. Over the last 50 years, extensive effort has been given to determining the optimal BP target for adults with HTN. Despite recent improvements in prescribing practices for evidencebased antihypertensive medication therapy, many diagnosed cases remain ‘‘uncontrolled.’’ Data from the National Health and Nutrition Examination Surve...

Pharmacotherapy, 2004

Hypertension is a key risk factor for cardiovascular disease. Current management of hypertension, both pharmacologic and nonpharmacologic, is based on an extensive amount of published literature. We present a list of publications, clinical trials, meta-analyses, and clinical practice guidelines that we believe are essential in defining the current practice standards in the management of hypertension.

Journal of the American Heart Association, 2015

Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Although this guideline provides evidence-based recommendations for the management of high BP and should meet the clinical needs of most patients, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient.

Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes.