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High blood pressure significantly increases cardiovascular disease risk, especially coronary heart disease. Managing hypertension involves addressing multiple risk factors for optimal prevention and treatment.
Area of Science:
- Cardiology
- Public Health
Background:
- Elevated blood pressure (hypertension) is a primary cause of cardiovascular disease (CVD), including coronary heart disease.
- Cardiovascular disease risk escalates with blood pressure levels, irrespective of age, sex, or pressure type (labile/fixed, diastolic/systolic).
Purpose of the Study:
- To highlight hypertension as a key component of a multivariate cardiovascular risk profile.
- To emphasize the need for multifactorial risk factor correction in hypertension management.
Main Methods:
- Review of existing literature on hypertension and cardiovascular disease risk factors.
- Analysis of the relationship between blood pressure, associated risk factors, and cardiovascular outcomes.
Main Results:
- Hypertension's impact on CVD is independent but greatly amplified by co-existing factors like hyperlipidemia, obesity, and hyperglycemia.
- Cardiovascular risk is highest in hypertensive individuals with elevated LDL/HDL cholesterol, impaired glucose tolerance, smoking, and ECG abnormalities.
- Risk severity correlates with the number and level of associated risk factors and target organ involvement.
Conclusions:
- Hypertension management should be integrated into a comprehensive cardiovascular risk profile assessment.
- Optimal preventive strategies require addressing all contributing risk factors before target organ damage occurs.
Abstract:
Elevated blood pressure is a major contributor to cardiovascular disease in general and to coronary heart disease in particular, now its most common sequela. The risk is proportional to the degree of blood pressure elevation, at all ages and in either sex, whether the increased pressure is labile or fixed, diastolic or systolic in character. The effect of blood pressure on cardiovascular disease incidence is independent of the influence of other predisposing co-factors, but the hazard is greatly influenced by them. Elevated pressures are often accompanied by hyperlipidaemia, hyperuricaemia, overweight, hyperglycaemia, elevated fibrinogen values and ECG abnormalities. The risk associated with any degree of elevation of pressure varies greatly, depending on the number and level of these often associated risk factors, and on whether or not there is the indication of target organ involvement. The excess cardiovascular risk in hypertensive persons tends to be concentrated in those with an increased LDL/HDL cholesterol ratio, impaired glucose tolerance, cigarette smokers and those with accompanying ECG abnormalities. Hypertension is best conceptualised as a component of a multivariate cardiovascular risk profile which provides a sound basis for determining urgency for drug treatment. Optimal preventive management of hypertension requires multifactorial correction of all disordered components of the cardiovascular risk profile before occurrence of target organ involvement.