An estimated 9.9 million Americans have hypertension and another 9.4 million have high blood pressure but are unaware of it. More specifically, there are 1.9 million with hypertension and hypertension-related heart disease.
A number of risk factors have been established, and it is difficult to predict what will come individually and for a family or cluster of families. The best thing to do to help prevent hypertension is to try to reduce the number of risk factors.
In hypertensive patients, arterial blood pressure should routinely be measured, since some patients feel dyspnea when blood pressure is >130/80 mm Hg, while others are asymptomatic. At a blood pressure of >130 mm Hg, it is extremely probable that at that point the atherosclerosis is already severely advanced; the patient therefore should be referred for coronary angiography to detect coronary artery disease (CAD). Also, the presence of heart failure or neurological signs warrants referral to a cardiologist to determine the necessity for immediate revascularization of the coronary arteries. In the present era of cardiology, angiography remains the gold standard for investigating CAD.
The majority of patients who are able to stop their medication feel as if they cured their hypertension, despite evidence of a low-normal blood pressure. Some patients, however, were able to achieve and keep a low-normal blood pressure without medications. There is a discrepancy in these patients' perceptions of their treatment, with many of them believing they have cured their hypertension.
Hypertension (high blood pressure) causes the buildup of plaque in aorta and can lead to heart valve disease, diabetes, and stroke. Chronic hypertension can lead to heart attack and can increase the risk of stroke, with or without hemorrhage.
There is an abundant evidence of the therapeutic effectiveness of lifestyle modification and behavioural programs for patients with hypertension. The use of antihypertensive medications such as thiazide diuretics and beta blockers is recommended especially in hypertensive patients over 60 years.
In summary, the majority of the drugs used to treat hypertension are not used for hypertensive diseases related to the heart and the kidneys. The current medications and therapies are still not effective and continue to be an area of scientific and medical interest. This is demonstrated by the number of medications used, the different types of side effects, and by the lack of more randomized, placebo-controlled, and/or large clinical studies. Nonetheless, some promising therapies have been found to be more effective for treating hypertension than conventional medication. Further, it may prove to be beneficial to take a holistic approach to the management of hypertension and consider all aspects of the patient's wellbeing and lifestyle.
The majority of patients who are treated with an alternative lifestyle intervention in combination with traditional treatments do not receive any other treatment in addition to standard therapy.
Despite the lack of clinical evidence to support their usage, ALI continued to be applied to a wide population across all ethnic groups in the study community. The reasons for its increased use in these populations remain unclear, however. Clearly, intervention strategies that promote good adherence and compliance to lifestyle recommendations are required if effective interventions are to be developed.
It is not clear now whether the age at which hypertension is diagnosed is increasing or whether the importance of timely diagnosis is being neglected. However, the mean age of diagnosis in women is lower than in men. Men tend to get hypertension at a later age.
There is no evidence that any alternative lifestyle intervention have been studied systematically in ethnic minorities. In order to test for evidence of efficacy it would be necessary to perform large, systematic investigations into the lifestyle, health and social interventions of this particular ethnically targeted population. These would be a daunting task and there is no obvious candidate for the 'lead' role in such trials.
Clinicians and their patients are currently the prime targets for enrollment in clinical trials as well as consumers of health care services for hypertension. However, given concerns about low health literacy, the availability of a simplified, portable version of the ECHI-R as a tool to enhance screening for hypertension, and research addressing how to enhance and improve provider-patient communication in order to increase the number of patients who participate in trials and reap the benefits of these trials, are potential enhancements that might increase the number of patients willing and eligible to participate in clinical trials for hypertension. ClinicalTrials.gov (U.S. National Library of Medicine, National Institutes of Health): NCT00918990.