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BACKGROUND: Cardiovascular disease (CVD), which affects 79.4 million Americans, is a relentless problem that continues to grow by leaps and bounds. OBJECTIVE: To review current perspectives on hypertension and metabolic syndrome. SUMMARY: Hypertension can be considered a national burden: 1 in 3 American adults are hypertensive, lifetime risk of developing hypertension exceeds 90%, and the total direct costs related to hypertension and its complications approaches $49.3 billion. The risk of CVDs doubles for every increment of 20/10 mm of mercury increase in blood pressure (BP), starting at 115/75 mm Hg. Untreated elevated systolic BP may galvanize artery stiffness, and coronary heart disease (CHD) risk rises as systolic BP rises. Thus, emphasis on diastolic pressure as a risk assessment tool can be misleading, particularly in advanced age. CONCLUSION: Other risk factors for CHD include elevated cholesterol, low high-density lipoprotein cholesterol (HDL-C), smoking, and diabetes. The relative risk of cardiovascular death is increased in hypertensive patients with history of stroke, diabetes, and kidney disease. Finally, metabolic syndrome, consisting of obesity, low HDL-C, and elevated BP, triglycerides, and fasting glucose, affects 47 million people and increases diabetes and CVD risk.

The Changing Landscape of Hypertension and the Evolving Role of Vasodilatory Beta-Blockers