Dysrhythmias and Hypertension

Cardiovascular disease is the leading cause of death in the world,[1] as well as the United States and India for the past 80+ years[2] and 16 years,[3] respectively. The death rate per 100,000 population in the United States is 262.3[4] and India is 209.1.[5] There are a variety of risk factors for cardiovascular disease, but likely none more significant than hypertension (HTN).[6] More than a quarter of the population of both the United States (29.0%)[7] and India (29.8%)[8] have a diagnosis of HTN. Despite the well understood morbidity and mortality associated with HTN, only 48.3% of the United States’[7] and 10.7–20.2% of India’s[8] hypertensive population are adequately treated. Historically, HTN has been defined as a blood pressure (BP) >140/90 mmHg,[9] but a change to >130/80 mmHg has been recommended[10] following the SPRINT Trial.[11] This is would result in a dramatic increase in the prevalence of HTN throughout the world, including up to 46% of the entire United States population.[12] The patients responsible for this increase in prevalence would primarily be younger,[13] which could be beneficial as several studies have shown that BP > 130/80 mmHg is associated with poorer outcomes in patients <65 years old.[14–16] In addition to ischemic heart disease, stroke, vascular disease, and renal insufficiency, HTN can cause hypertensive heart disease, even with BPs of 120–139/80–89 mmHg.[17,18] Hypertensive Heart Disease