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Hypertension control: multifactorial contributions
1Orange County Heart Institute and Research Center, Orange, California 92868, USA.
Insights
Hypertension may be part of a larger inherited hypertension syndrome, with cardiovascular risks appearing before high blood pressure. Early detection of this syndrome could prevent related diseases.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Hypertension treatment reduces some cardiovascular risks but not all.
- A new theory proposes hypertension is part of a broader inherited hypertension syndrome.
- Cardiovascular disease may precede elevated blood pressure in some individuals.
Purpose of the Study:
- To explore the concept of the hypertension syndrome.
- To investigate the early manifestations of cardiovascular disease risk factors.
- To determine if early detection of hypertension syndrome components can prevent cardiovascular disease.
Main Methods:
- Review of existing epidemiologic studies.
- Analysis of findings related to inherited risk factors for hypertension.
- Examination of early markers associated with cardiovascular disease.
Main Results:
- Normotensive individuals with a family history of hypertension show similar disease processes and prognoses to hypertensives.
- Inherited abnormalities predispose individuals to hypertension and associated cardiovascular risk factors.
- Components of hypertension syndrome include elevated lipids, left ventricular hypertrophy, arterial stiffening, insulin resistance, renal, and neuroendocrine changes.
Conclusions:
- Hypertension syndrome may be reversible if diagnosed early, potentially before high blood pressure onset.
- Elevated blood pressure might be a marker for irreversible vascular disease.
- Early detection of hypertension syndrome components may delay or prevent cardiovascular disease in high-risk patients.
Abstract:
Treatment of hypertension reduces the risk of several associated deleterious conditions, although it does not lower risk for all cardiovascular diseases. A new theory suggests that high blood pressure is but one piece in the puzzle of a complex syndrome of inherited risk factors called the hypertension syndrome. Several new findings have emerged theorizing that patients may have coronary artery disease before the actual onset of elevated blood pressure. Epidemiologic studies have found that normotensive patients with a family history of hypertension often have a disease process and prognosis similar to that of hypertensives. It seems that some patients may "inherit" abnormalities that make them prone to the development of hypertension, as well as a complex series of cardiovascular disease risk factors. These include elevated lipids, increased left ventricular hypertrophy, arterial stiffening, insulin resistance, renal function abnormalities, and neuroendocrine changes. It is conceivable that the hypertension syndrome may be reversible if the disease process is diagnosed early, which appears to be well before the actual onset of high blood pressure. High blood pressure may be a risk marker for irreversible vascular disease and early detection of the many components of hypertension syndrome may delay or prevent cardiovascular disease from developing in high-risk patients.