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[Hypertension: when to consider it a risk factor?]
1Cattedra di Medicina interna, Università, Padova.
Insights
Mild hypertension may pose significant cardiovascular risks when linked with specific factors like left ventricular hypertrophy. These findings impact understanding and treatment of high blood pressure.
Area of Science:
- Cardiology
- Hypertension Research
- Epidemiology
Background:
- Large epidemiological studies over 30 years confirm moderate to severe arterial hypertension as a major cardiovascular disease risk factor.
- Mild hypertension has historically been considered less concerning unless other risk factors are present.
Discussion:
- Recent research focuses on identifying additional risk factors that exacerbate the cardiovascular risk associated with mild hypertension.
- Key implicated factors include left ventricular hypertrophy, renin-angiotensin system activation, and increased Na+/Li+ countertransport.
Key Insights:
- These identified factors are crucial in the pathophysiology of hypertensive cardiovascular disease.
- Not all antihypertensive medications effectively address these specific contributing factors.
Outlook:
- These insights have significant pathophysiological and clinical implications for managing hypertension.
- Further research may lead to new therapeutic strategies targeting these specific risk factors for improved patient outcomes.
Abstract:
The results of a good deal of large epidemiological studies carried out in the last 3 decades clearly showed that moderate and severe arterial hypertension is a mayor risk factor for cardiovascular disease. At variance, mild hypertension was generally regarded as a more benign condition, if not associated with other risk factors. Recently, the attention of several investigators was focussed to identifying possible additional risk factors, which are related to high blood pressure, and might increase substantially the risk of mild blood pressure elevation. Left ventricular hypertrophy, activation of the renin-angiotensin system and a generalized increase in the Na+/Li+ countertransport are some of the factors that are implicated in hypertensive cardiovascular disease. Since not all available antihypertensive agents positively influence these factors, these observations could have not only pathophysiological and clinical, but also therapeutic consequences.