EDITORIAL-Blood Pressure as a Risk Factor of Global Disease Burden and its Association with Lifetime Risks of Different Manifestations of Cardiovascular Disease

Abstract

The evaluation of lifetime cardiovascular disease (CVD) risk and the life-years lost due to CVD in specific age groups in a population of 1.25 million people showed that not all elements of hypertension are causally associated with all manifestations of CVD. High systolic blood pressure (BP) was strongly related to intracerebral haemorrhage, subarachnoid haemorrhage, stable angina, myocardial infarction, and peripheral arterial disease (PAD). On the other hand, high diastolic BP had a stronger relationship with abdominal aortic aneurysm and pulse pressure had a stronger association with PAD and an inverse association with abdominal aortic aneurysm. Unstable angina was related to loss of life in younger ages, whereas heart failure and stable angina pectoris were related to years of life lost in the elderly. Thus, specific elements of BP were linked to specific manifestations of CVD and causes of death by CVD. Another recent study analysed the independent effects of 67 all-disease risk factors in 21 regions worldwide in 2010 and compared them with those of 1990. Hypertension immerged as the first cause of all-cause disease burden (7%), while in 1990 it was not included in the first 3 causes. A shift from communicable diseases of the children to the non-communicable diseases of the adults was also recorded in this 20-year period. A plethora of data suggests the hypertension is the number one killer both in Western World and Worldwide. The adoption of lifetime CVD risk estimates combined with efforts for increased awareness, education, and BP control will probably improve outcomes and substantially reduce CVD mortality.