Related Research Articles
Cardiology is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease, and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a sub-specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.
Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" refers to the pressure in a brachial artery, where it is most commonly measured. Blood pressure is usually expressed in terms of the systolic pressure over diastolic pressure in the cardiac cycle. It is measured in millimeters of mercury (mmHg) above the surrounding atmospheric pressure, or in kilopascals (kPa). The difference between the systolic and diastolic pressures is known as pulse pressure, while the average pressure during a cardiac cycle is known as mean arterial pressure.
Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms itself. It is, however, a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide.
A hypertensive urgency is a clinical situation in which blood pressure is very high with minimal or no symptoms, and no signs or symptoms indicating acute organ damage. This contrasts with a hypertensive emergency where severely high blood pressure is accompanied by evidence of progressive organ or system damage.
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood.
Antihypertensives are a class of drugs that are used to treat hypertension. Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke, heart failure, kidney failure and myocardial infarction. Evidence suggests that reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21%, and can reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists (ARBs), and beta blockers.
Pulmonary hypertension is a condition of increased blood pressure in the arteries of the lungs. Symptoms include shortness of breath, fainting, tiredness, chest pain, swelling of the legs, and a fast heartbeat. The condition may make it difficult to exercise. Onset is typically gradual. According to the definition at the 6th World Symposium of Pulmonary Hypertension in 2018, a patient is deemed to have pulmonary hypertension if the pulmonary mean arterial pressure is greater than 20mmHg at rest, revised down from a purely arbitrary 25mmHg, and pulmonary vascular resistance (PVR) greater than 3 Wood units.
Essential hypertension is a form of hypertension without an identifiable physiologic cause. It is the most common type affecting 85% of those with high blood pressure. The remaining 15% is accounted for by various causes of secondary hypertension. Essential hypertension tends to be familial and is likely to be the consequence of an interaction between environmental and genetic factors. Hypertension can increase the risk of cerebral, cardiac, and renal events.
Valsartan, sold under the brand name Diovan among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It belongs to a class of medications referred to as angiotensin II receptor blockers (ARBs). It is a reasonable initial treatment for high blood pressure. It is taken by mouth.
Secondary hypertension is a type of hypertension which has a specific and identifiable underlying primary cause. It is much less common than essential hypertension, affecting only 5-10% of hypertensive patients. It has many different causes including obstructive sleep apnea, kidney disease, endocrine diseases, and tumors. The cause of secondary hypertension varies significantly with age. It also can be a side effect of many medications.
Hypertensive heart disease includes a number of complications of high blood pressure that affect the heart. While there are several definitions of hypertensive heart disease in the medical literature, the term is most widely used in the context of the International Classification of Diseases (ICD) coding categories. The definition includes heart failure and other cardiac complications of hypertension when a causal relationship between the heart disease and hypertension is stated or implied on the death certificate. In 2013 hypertensive heart disease resulted in 1.07 million deaths as compared with 630,000 deaths in 1990.
The Dietary Approaches to Stop Hypertension or the DASH diet is a diet to control hypertension promoted by the U.S.-based National Heart, Lung, and Blood Institute, part of the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services. The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy foods. It includes meat, fish, poultry, nuts, and beans, and is limited in sugar-sweetened foods and beverages, red meat, and added fats. In addition to its effect on blood pressure, it is designed to be a well-balanced approach to eating for the general public. DASH is recommended by the United States Department of Agriculture (USDA) as a healthy eating plan. The DASH diet is one of three healthy diets recommended in the 2015–20 U.S. Dietary Guidelines, which also include the Mediterranean diet and a vegetarian diet. The American Heart Association (AHA) considers the DASH diet "specific and well-documented across age, sex and ethnically diverse groups."
Arterial stiffness occurs as a consequence of biological aging and arteriosclerosis. Inflammation plays a major role in arteriosclerosis development, and consequently it is a major contributor in large arteries stiffening. Increased arterial stiffness is associated with an increased risk of cardiovascular events such as myocardial infarction, hypertension, heart failure and stroke, the two leading causes of death in the developed world. The World Health Organization predicts that in 2010, cardiovascular disease will also be the leading killer in the developing world and represents a major global health problem.
Prehypertension, also known as high normal blood pressure and borderline hypertensive (BH), is a medical classification for cases where a person's blood pressure is elevated above optimal or normal, but not to the level considered hypertension. Prehypertension is now referred to as "elevated blood pressure" by the American College of Cardiology (ACC) and the American Heart Association (AHA). The ACC/AHA define elevated blood pressure as readings with a systolic pressure from 120 to 129 mm Hg and a diastolic pressure under 80 mm Hg, Readings greater than or equal to 130/80 mm Hg are considered hypertension by ACC/AHA and if greater than or equal to 140/90 mm Hg by ESC/ESH. and the European Society of Hypertension defines "high normal blood pressure" as readings with a systolic pressure from 130 to 139 mm Hg and a diastolic pressure 85-89 mm Hg.
Central aortic blood pressure is the blood pressure at the root of aorta. Studies have shown the importance of central aortic pressure, especially as compared to peripheral blood pressure, and its implications in assessing the efficacy of antihypertensive treatment with respect to cardiovascular risk factors, kidney disease, and mortality. There is an emerging movement for clinicians to begin using central aortic blood pressure, instead of peripheral blood pressure, as a guide for clinical decisions.
Orthostatic hypertension is a medical condition consisting of a sudden and abrupt increase in blood pressure (BP) when a person stands up. Orthostatic hypertension is diagnosed by a rise in systolic BP of 20 mmHg or more when standing. Orthostatic diastolic hypertension is a condition in which the diastolic BP raises to 98 mmHg or over in response to standing, but this definition currently lacks clear medical consensus, so is subject to change. Orthostatic hypertension involving the systolic BP is known as systolic orthostatic hypertension.
Arterial blood pressure is most commonly measured via a sphygmomanometer, which historically used the height of a column of mercury to reflect the circulating pressure. Blood pressure values are generally reported in millimetres of mercury (mmHg), though modern aneroid and electronic devices do not contain mercury.
Hypertension is managed using lifestyle modification and antihypertensive medications. Hypertension is usually treated to achieve a blood pressure of below 140/90 mmHg to 160/100 mmHg. According to one 2003 review, reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21% and reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease.
Stefan D. Anker is a German cariologist who is Head of Field “Tissue Homeostasis and Cachexia" at Charité University, Berlin, Germany. Previously, he was Professor of Innovative Clinical Trials at University Medical Center Göttingen in Germany. The main focus of the Innovative Clinical Trials department was research in the field of chronic heart failure, including the development and clinical testing of new therapies.
non-pharmacological intervention (NPI) is any type of healthcare intervention which is not primarily based on medication. Some examples include exercise, sleep improvement, and dietary habits.
References
- 1 2 James, PA.; Oparil, S.; Carter, BL.; Cushman, WC.; Dennison-Himmelfarb, C.; et al. (Dec 2013). "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.
- ↑ McEvoy, John William; McCarthy, Cian P; Bruno, Rosa Maria; Brouwers, Sofie; Canavan, Michelle D; et al. (2024-08-30). "2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO)". European Heart Journal. doi: 10.1093/eurheartj/ehae178 . ISSN 0195-668X.
- ↑ Mancia, Giuseppe; Kreutz, Reinhold; Brunström, Mattias; Burnier, Michel; Grassi, Guido; et al. (2023-12-01). "2023 ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)". Journal of Hypertension. 41 (12): 1874–2071. doi: 10.1097/HJH.0000000000003480 . hdl: 11379/603005 . ISSN 1473-5598. PMID 37345492.
- ↑ Coles, Sarah; Fisher, Lynn; Lin, Kenneth W.; Lyon, Corey; Vosooney, Alexis A.; Bird, Melanie D. (December 2022). "Blood Pressure Targets in Adults With Hypertension: A Clinical Practice Guideline From the AAFP". American Family Physician. 106 (6): Online. ISSN 1532-0650. PMID 36521481.
- ↑ Clarke, S. Lindsey (October 2023). "Hypertension in Adults: Initial Evaluation and Management". American Family Physician. 108 (4): 352–359. ISSN 1532-0650. PMID 37843942.
- ↑ Guideline for the pharmacological treatment of hypertension in adults (PDF). World Health Organization (WHO). 2021. ISBN 9789240033993 . Retrieved 2024-05-26.
- ↑ Cheung, Alfred K.; Chang, Tara I.; Cushman, William C.; Furth, Susan L.; Hou, Fan Fan; et al. (March 2021). "KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease". Kidney International. 99 (3): S1–S87. doi: 10.1016/j.kint.2020.11.003 .
- ↑ Unger, Thomas; Borghi, Claudio; Charchar, Fadi; Khan, Nadia A.; Poulter, Neil R.; et al. (2020-05-06). "2020 International Society of Hypertension Global Hypertension Practice Guidelines". Hypertension. 75 (6): 1334–1357. doi: 10.1161/HYPERTENSIONAHA.120.15026 . hdl: 10394/34842 . ISSN 0194-911X.
- ↑ U.S. Department of Veterans Affairs. "VA/DoD clinical practice guideline for the diagnosis and management of hypertension in the primary care setting". VA/DoD Clinical Practice Guidelines. Retrieved 2024-03-25.
- ↑ "Hypertension in adults: diagnosis and management |". National Institute for Health and Clinical Excellence (NICE). 2019-08-28. Retrieved 2024-03-24.
- ↑ Passarella, Pasquale; Kiseleva, Tatiana A.; Valeeva, Farida V.; Gosmanov, Aidar R. (2018-08-01). "Hypertension Management in Diabetes: 2018 Update". Diabetes Spectrum. 31 (3): 218–224. doi:10.2337/ds17-0085. ISSN 1040-9165. PMC 6092891 . PMID 30140137.
- ↑ Williams, Bryan; Mancia, Giuseppe; Spiering, Wilko; Agabiti Rosei, Enrico; Azizi, Michel; et al. (1 September 2018). "2018 ESC/ESH Guidelines for the management of arterial hypertension". European Heart Journal. 39 (33): 3021–3104. doi:10.1093/eurheartj/ehy339. PMID 30165516.
- ↑ Whelton, Paul K.; Carey, Robert M.; Aronow, Wilbert S.; Casey, Donald E.; Collins, Karen J.; et al. (2018-05-15). "2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults". Journal of the American College of Cardiology. 71 (19): e127–e248. doi:10.1016/j.jacc.2017.11.006. PMID 29146535.
- ↑ Hackam, Daniel G.; Quinn, Robert R.; Ravani, Pietro; Rabi, Doreen M.; Dasgupta, Kaberi; et al. (May 2013). "The 2013 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension". Canadian Journal of Cardiology. 29 (5): 528–542. doi:10.1016/j.cjca.2013.01.005.
- ↑ Flack, John M.; Sica, Domenic A.; Bakris, George; Brown, Angela L.; Ferdinand, Keith C.; et al. (November 2010). "Management of High Blood Pressure in Blacks: An Update of the International Society on Hypertension in Blacks Consensus Statement". Hypertension. 56 (5): 780–800. doi:10.1161/HYPERTENSIONAHA.110.152892. ISSN 0194-911X.