Epidemiology of hypertension as a guide to treatment and control

Knowledge of the epidemiology of hypertension can be used as an excellent guide in treatment and control of hypertension in the community. Available evidence on the epidemiology of hypertension that has direct bearing on clinical decisions for diagnosis and treatment can be listed as follows: 1. Frequently distribution of arterial blood pressure in a population of unimodal and continuous. 2. The adverse effects of high blood pressure (e.g., death) are related numerically to the level of blood pressure, both systolic and diastolic. 3. Prevalence of actual hypertension in the community depends upon the variability of blood pressure between occasions of measurement, and the arbitrary cutoff points used in screening. 4. Prevalence rates of actual hypertension in the community are the same for men and women and differ by race; the rate is higher in black than in white subjects. 5. Although the proportion of those cases of hypertension under control has increased dramatically in the United States communities since 1974, a disparity exists between men and women in the degree of their hypertension control. More women (black and white) than men have their hypertension under control. 6. There is an interaction between blood pressure and other risk factors. Decision on treatment should be based on total health profiles of the patient and not just the level of blood pressure. 7. Results of recent experimental epidemiologic studies (HDFP) indicate that judicious and rigorous treatment of mild hypertension in the community is feasible and that such a treatment is successful in reducing total mortality rate in the community by at least 17%.