A hypertensive patient may be taking drugs for hypertension that cause hypertension. Physicians should consider prescribing antihypertensives as a last resort only, as they can exacerbate hypertension and therefore may contribute to adverse cardiovascular outcomes.
Hypertension is a condition that causes persistent high blood pressure. It is a major risk factor for coronary heart disease (CHD) and stroke. People with hypertension are about 25 times more likely to have a stroke than those who do not have hypertension. Hypertension is a modifiable risk factor for stroke and is therefore an important target for reducing stroke rates. Chronic hypertension (hypertension lasting more than 3 months) is also associated with cardiovascular morbidity and mortality; it is an independent risk factor for CHD and stroke, and the occurrence of CHD and stroke is related to the degree of hypertension.
Even though hypertension is largely caused by dietary habits, many other factors are involved in the progression of hypertension. Therefore, it is difficult to cure hypertension solely with diet. However, it is noteworthy that a simple program of diet and exercise can reduce the progress and severity of hypertension.
High blood pressure is a very commonly neglected, but significant medical condition. Many physicians who do not specialize in the treatment and prevention of hypertension may be at risk of failing to treat hypertensive patients appropriately if they are not even aware of the disease. Consequently, patients must be evaluated periodically for blood pressure control both to avoid complications and to provide optimal treatment. Therefore, measurement of the vital signs should remain in the routine clinical care for all patients with hypertension.
The current study is the first to provide a comprehensive, population-based estimate of the number of US youth who have hypertension and at what age they are diagnosed. Findings from a recent study suggest that hypertensive youth may be more likely to be diagnosed at younger ages than are youth on antihypertensive therapies. While this study provides a valid and informative estimate of the prevalence of hypertension among the youth of the United States, our finding that a portion of these youth were unaware of their hypertension status has significant clinical relevance for clinicians treating this population. We believe that the data presented here can inform interventions aimed at preventing and treating this disease early on in its trajectory.
Given the complexity of hypertension, a simplistic definition of the disorder cannot be assumed. Recent findings, the risk factors of hypertension were largely stable over time. There was a strong relationship between family history of hypertension and future hypertension. Hypertension was most closely associated with increased blood pressure variability, lower HDL cholesterol, and with metabolic risk factors.
In addition to monotherapy, a sizeable proportion of hypertensive patients (27.3%) would be treated with some combination of a different drug. Thus physicians can broaden the range of therapeutic options for their patients.
Telmisartan 20 mg/amlodipine 2.5 mg/indapamide 1.25 mg is well tolerated when combined with other antihypertensive agents, especially when taken before meals. However, telmisartan 20 mg/amlodipine 2.5 mg/indapamide 1.25 mg should be taken with caution in patients with hepatic failure or impaired renal function.
The relative risks and numbers-in-hand of the three drugs in the first phase were comparable. Telmisartan 20 mg/amlodipine 2.5 mg/indapamide 1.25 mg showed a statistically significant advantage over a placebo regarding a number of primary and secondary endpoints from the pooled results of the two groups treated in phase IIb.
Telmisartan at 20 mg and amlodipine at 5 mg worked well in the majority of the subjects: >80% of those who improved, and >60% improved to the therapeutic range. Telmisartan-amlodipine treatment may be a viable option for people with mild to moderate hypertension, or people who cannot go on to other medications such as beta-blockers and/or ACE inhibitors.
About 75% of male and women get hypertension at an average age of 55.6 and 54.9 yrs respectively and this is the highest prevalence of essential hypertension in the world. This also indicates the necessity of early identification of hypertension and treatment in childhood and young adult age which would avert long-term health burden due to complications like stroke and chronic kidney disease in addition to hypertension-related cardiovascular complications.
In patients with uncomplicated hypertension there remains a group of patients who have a low likelihood of benefiting from the information provided regarding the benefits and harms of an intervention. Such patients should not generally be referred to clinical trials until a second, more comprehensive study has confirmed their low risk of benefit (e.g., when it can be ascertained that they will not be harmed).