BP control remains an important strategy for reducing CV disease (CVD) mortality. The prospective urban rural epidemiology (PURE) study evaluated HTN awareness, treatment and control in 17 countries at various stages of economic development. [4] Among the 142,042 participants, 40.8% had HTN and 46.5% were aware of the diagnosis. Among those who were aware of the diagnosis, the majority (87.5% of those who were aware) were receiving pharmacological treatments, but only 32.5% of those receiving treatment were controlled. The percentages of those aware were 49.0% in high-income countries (HICs), 52.5% in upper middle-income countries (UMICs), 43.6% in lower middle-income countries (LMICs), and 40.8% in lower income
AbstractHypertension (HTN) is a major modifiable independent risk factor for coronary artery disease (CAD) for all age, race, and sex groups. HTN initiates and accelerates the development of atherosclerosis. Sustained elevation of blood pressure (BP) can precipitate acute coronary events by destabilizing vascular lesions. The cardiovascular risks attributed to uncontrolled HTN can be reduced by optimal BP control. Varying therapeutic goals for BP control and availability of numerous antihypertensives make the management of HTN in patients with CAD controversial. This article examines the pathophysiological mechanisms that link HTN with CAD and discusses the available treatment options and therapeutic goals that are consistent with recently published American College of Cardiology/American Heart Association guidelines for the prevention, detection, evaluation, and management of high BP in adults published in 2017.