High Blood Pressure and Cardiovascular Disease

Abstract

Fragmented investigation has masked the overall picture for causes of cardiovascular disease (CVD). Among the risk factors for CVD, high blood pressure (BP) is associated with the strongest evidence for causation and it has a high prevalence of exposure. Biologically, normal levels of BP are considerably lower than what has typically been characterized as normal in research and clinical practice. We propose that CVD is primarily caused by a right-sided shift in the population distribution of BP. Our view that BP is the predominant risk factor for CVD is based on conceptual postulates that have been tested in observational investigations and clinical trials. Large cohort studies have demonstrated that high BP is an important risk factor for heart failure, atrial fibrillation, chronic kidney disease, heart valve diseases, aortic syndromes, and dementia, in addition to coronary heart disease and stroke. In multivariate modeling, the presumed attributable risk of high BP for stroke and coronary heart disease has increased steadily with progressive use of lower values for normal BP. Meta-analysis of BP-lowering randomized controlled trials has demonstrated a benefit which is almost identical to that predicted from BP risk relationships in cohort studies. Prevention of age-related increases in BP would, in large part, reduce the vascular consequences usually attributed to aging, and together with intensive treatment of established hypertension would eliminate a large proportion of the population burden of BP-related CVD.

Life-course blood pressure trajectories and cardiovascular diseases: A population-based cohort study in China

“…Our findings imply the importance of preventing rapid increase in SBP along with age. This is also pointed by a recent review on high blood pressure and CVDs, which showed that it is the time to pay greater attention to the prevention of the typical age-related increase in blood pressure in addition to the intensive treatment of established hypertension to eliminate the population burden of blood pressure related CVDs [27]. In addition, people with "fluctuant" SBP trajectory also had a significantly higher risk of CVDs, but the association disappeared after the adjustment of antihypertensive medications.…”

Awareness of cardiovascular disease associated risk factors among Saudis in Riyadh City

“…[ 15 16 ] Indeed, it has been shown that most CVDs can be prevented by improving awareness about primary prevention or secondary, by modifying the risk factors such as tobacco use, obesity, physical inactivity, high blood pressure, and unhealthy diet, or using medication such as aspirin and blood pressure lowering agents. [ 17 18 19 20 ]…”

<p>Approaches to the Management of Hypertension in Resource-Limited Settings: Strategies to Overcome the Hypertension Crisis in the Post-COVID Era</p>

“…For cardiovascular disease, a major manageable risk factor fueling poor outcomes is uncontrolled hypertension. 9,10 Beyond being an atherogenic factor for cardiovascular disease, hypertension is extremely prevalent and affects as many 1.4 billion individuals globally, which leads to a compounding of its impact. 11 On the flip side, hypertension can be easily diagnosed, and in most cases, readily controlled.…”