Hypertension

Abstract

Systemic arterial hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and is associated with an increased risk of cardiovascular disease (CVD). Fewer than half of those with hypertension are aware of their condition, and many others are aware but not treated or inadequately treated, although successful treatment of hypertension reduces the global burden of disease and mortality. The aetiology of hypertension involves the complex interplay of environmental and pathophysiological factors that affect multiple systems, as well as genetic predisposition. The evaluation of patients with hypertension includes accurate standardized blood pressure (BP) measurement, assessment of the patients' predicted risk of atherosclerotic CVD and evidence of target-organ damage, and detection of secondary causes of hypertension and presence of comorbidities (such as CVD and kidney disease). Lifestyle changes, including dietary modifications and increased physical activity, are effective in lowering BP and preventing hypertension and its CVD sequelae. Pharmacological therapy is very effective in lowering BP and in preventing CVD outcomes in most patients; first-line antihypertensive medications include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, dihydropyridine calcium-channel blockers and thiazide diuretics.

Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine

“…The complexity of blood pressure regulation is amplified in an estimated 25% of adults with essential hypertension. 27 The uncoupling of mechanisms regulating blood volume, ventricular function, central and peripheral autonomic control, neurohormonal activation via the renineangiotensinealdosterone system, and endothelial release of nitric oxide disrupts blood pressure, blood pressure variability, or both. The role of salt sensitivity in hypertensive individuals highlights the potential impact of increased sodium administration, which is a crucial regulator of blood volume.…”

First‐dose effect of the SGLT2 inhibitor ipragliflozin on cardiovascular activity in spontaneously diabetic Torii fatty rats

“…Hypertension is known to injure blood vessels and consequently cause end‐organ damage . In fact, systemic hypertension is the most important modifiable risk factor for all‐cause morbidity and mortality worldwide . Further, the standard deviation of blood pressure values has been shown to be related to the progression of organ damage .…”

Association between Single Nucleotide Polymorphisms in Cardiovascular Developmental Critical Genes and Hypertension: A Propensity Score Matching Analysis

“…Hypertension is a common chronic disease and a major risk factor for stroke, myocardial infarction, and kidney failure [1,2]. Single nucleotide polymorphisms (SNPs) are DNA sequence polymorphisms caused by a single nucleotide variation at the genome level and are the most common human genetic variants [3].…”