He's "Epidemiology and Prevention of Hypertension" 1997

From Biol557

Contents 1 Introduction 2 Distribution of hypertension in populations 2.1 Classification of hypertension 2.2 Age and hypertension 2.3 Gender and hypertension 2.4 Ethnicity and hypertension 2.5 Secular Trends in Prevalence and Incidence of Hypertension 3 HYPERTENSIONAND RISK OF CARDIOVASCULARRENAL DISEASE 4 PRIMARY PREVENTION OF HYPERTENSION 4.1 Weight loss 4.2 Dietary Sodium Reduction 4.3 Moderation in Alcohol Consumption 4.4 Potassium Supplementation 5 Conclusion

[edit] Introduction

• Hypertension is really important because lots of people have it, we spend lots of money on treating those people, and it is an important factor in many of the diseases that are the leading causes of death.

[edit] Distribution of hypertension in populations

[edit] Classification of hypertension

• From an important report:
  • Normal: systolic blood pressure less than 120 mm Hg and a diastolic blood pressure less than 80 mm Hg.
  • High normal: systolic blood pressure between 130 and 139 mm Hg or diastolic blood pressure between 85 and 89 mm Hg
  • Hypertensive: systolic greater than or equal to 140 mm Hg or diastolic greater than or equal to 90 mm Hg
• There are four stages of hypertension determined by the blood pressure.

[edit] Age and hypertension

• While hypertension increases with age, it is also a function of race, gender, "stage of life", environmental factors, and initial level of blood pressure.
• "In general, the rise in hypertension prevalence with age is steeper in populations in which hypertension is more common."
• "The age-related rate of rise in blood pressure is consistently greater for systolic than for diastolic blood pressure. Systolic blood pressure tends to rise until the 70s or 80s, whereas diastolic blood pressure tends to remain constant or decline after the 40s."

[edit] Gender and hypertension

• "Overall the prevalence and incidence of hypertension are slightly higher in men compared to women."
• "The age-related rise in blood pressure during adulthood is, however, steeper for women than for men. ... Consequently the prevalence of hypertension is higher in women than in men late in life."

[edit] Ethnicity and hypertension

• "African-Americans have a higher prevalence and incidence of hypertension compared to whites."
• "In most studies, the prevalence of hypertension was increased about 50% in African-Americans compared to whites."
• "The prevalence and incidence of hypertension is similar or lower in Mexican-Americans than in non-Hispanic whites."
• "Asian-Americans have a substantially lower prevalence of hypertension compared to other ethnic groupS."
• "The prevalence of hypertension varies greatly in Native Americans."

[edit] Secular Trends in Prevalence and Incidence of Hypertension

• "In [the Farmingham study], no consistent secular trend in hypertension incidence was evident for either sex from the 1950s through the 1970s."

[edit] HYPERTENSIONAND RISK OF CARDIOVASCULARRENAL DISEASE

• "The combined results demonstrated a positive, continuous, and independent association between blood pressure and the incidence of coronary heart disease and stroke."
• Hypertension was equally associated with stroke and renal failure.
• "In clinical trials, antihypertensive drug therapy reduces the risk of cardiovascular disease and stroke."

[edit] PRIMARY PREVENTION OF HYPERTENSION

• We need to get the entire population to shift their blood pressure downward slightly.
• We need to help at-risk subpopulations to decrease their blood pressure significantly.
• "It is estimated that a populationwide reduction in diastolic pressure of as little as 2 mm Hg would result in a 17% reduction in the prevalence of hypertension as well as a 15% reduction in the risk of stroke and transient ischemic attacks and a 6% reduction in the risk of coronary heart disease."

[edit] Weight loss

• "Both cross-sectional and longitudinal studies have consistently identified an association between overweight and hypertension, independent of age.43 Several clinical trials have also shown a blood pressure-lowering effect of weight loss."

[edit] Dietary Sodium Reduction

• "Results from both observational "epidemiologic studies and randomized controlled trials have identified a dose-response association between dietary sodium and blood pressure in human populations."

[edit] Moderation in Alcohol Consumption

• "...men who consumed three to five drinks of alcohol per day had systolic and diastolic pressures that were, on average, 2.7 and 1.6 mm Hg higher than those in their counterparts who were nondrinkers."
• Results for women followed the same trend.

[edit] Potassium Supplementation

• "Overall, potassium

supplementation was associated with a mean systolic blood pressure reduction of -3.1 mm Hg and diastolic blood pressure reduction of -2.0 mm Hg."

[edit] Conclusion

• See summary.