Open AccessAssessment of Global Risk: A Foundation for a New, Better Definition of Hypertension
Author(s) -
Giles Thomas D.
Publication year - 2006
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2006.05835.x
Subject(s) - medicine , prehypertension , blood pressure , microalbuminuria , arterial stiffness , cardiology , pulse pressure , pulse wave velocity , left ventricular hypertrophy , context (archaeology) , diastole , etiology , essential hypertension , intensive care medicine , paleontology , biology
The prevalence of individuals with increased blood pressure (BP) is growing. A greater understanding of the various pathogenetic mechanisms of hypertension and associated BP increases would provide a better strategy for preventing and treating this condition. Hypertension is strongly associated with other cardiovascular risk factors. Additionally, there is no threshold of BP >115/70 mm Hg that identifies cardiovascular risk (i.e., risk is linear and doubles for each 20/10‐mm Hg BP rise). These insights have led a group of hypertension experts to propose a new definition of hypertension as “a progressive cardiovascular syndrome arising from complex and interrelated etiologies,” which features early markers that are “often present before blood pressure elevation is sustained.” Early cardiovascular markers include widened pulse pressure, left ventricular hypertrophy, increased arterial stiffness, endothelial dysfunction, and microalbuminuria. Importantly, antihypertensive treatment for patients with prehypertension (systolic BP of 120–139 mm Hg or diastolic BP of 80–89 mm Hg) has recently been shown to prevent the development of frank hypertension. This revision of the definition of hypertension and the need to assess BP levels in the context of global cardiovascular risk should lead to earlier detection of at‐risk patients.