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Treatment in the Context of Other Diseases
Author(s) -
Nesbitt Shawna
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.313.3
Subject(s) - medicine , blood pressure , prehypertension , context (archaeology) , gout , etiology , intensive care medicine , framingham heart study , heart failure , disease , framingham risk score , paleontology , biology
Hypertension is present in nearly 30% of US adults and it accounts for many visits to physicians. It contributes to 77% of first strokes, 69% of first myocardial infarctions, and cost $66.4 billion. The onset of hypertension occurs in middle age most often and increases with aging. In Framingham, hypertension frequently occurs in the setting of other cardiovascular risk factors. Similarly in prehypertension as shown in the TROPHY study, elevated blood pressure rarely occurs without concurrent risk factors. Seventy three percent of type 2 diabetics have hypertension, and it is the second leading cause of renal failure. Thus treating hypertension in the setting of other diseases is increasingly more common. In addition, noncardiovascular diseases such as gout, asthma and arthritis frequently coexist in these patients. As mortality has improved in diseases such as cancer and HIV, chronic medical conditions such as hypertension have become prominent. While the etiology of these diseases is not related, the treatment for these conditions may affect blood pressure or its treatment. There are specific indications for various classes of antihypertensives. Clinical trial data suggest that most hypertensives require more than 2 medications. In addition, hypertensive medications have some synergy between specific agents. This requires thoughtful consideration on the selection of agents for complex patients.