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Hypertension
Hypertension doubles the risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease.
Hypertension is often associated with additional cardiovascular disease risk factors, and the risk of cardiovascular disease increases with the total burden of risk factors.
Although antihypertensive therapy clearly reduces the risks of cardiovascular and renal disease, large segments of the hypertensive population are either untreated or inadequately treated
Epidemiology
Blood pressure levels, the rate of age-related blood pressure increase
Hypertension is present in all populations except for a small number of individuals
hypertension accounts for 6% of deaths worldwide .
In the United States, average systolic blood pressure is higher for men than for women during early adulthood, although among older individuals the age-related rate of rise is steeper for women
, among individuals age 60 and older, systolic blood pressures of women are higher than those of men
Among adults, diastolic blood pressure also increases progressively with age until ~55 years, after which it tends to decrease. The consequence is a widening of pulse pressure (the difference between systolic and diastolic blood pressure) beyond age 60 .
Prevalence
28.7% (age-adjusted prevalence) of U.S. adults
The burden of hypertension increases with age, and among individuals aged 60, hypertension prevalence is 65.4%
Recent evidence suggests that the prevalence of hypertension in the United States may be increasing, possibly as a consequence of increasing obesity .
factors may contribute hypertension prevalence
Both environmental and genetic factors
Obesity and weight gain are strong, independent risk factors for hypertension
dietary NaCl intake
Low dietary intakes of calcium and potassium
alcohol consumption
psychosocial stress
and low levels of physical activity.
blood pressure heritabilities are in the range of 15–35%.
Mechanisms of Hypertension
factors involved in the regulation of both normal and elevated arterial pressure:
Intravascular Volume
Autonomic Nervous System
Renin-angiotensin-aldosterone axis