Document Detail

An integrated view of hypertension.
MedLine Citation:
PMID:  2607526     Owner:  NLM     Status:  MEDLINE    
Hypertension increases cardiovascular morbidity and mortality two to four-fold. The chief hazards are now atherosclerosis and coronary disease. The risk is proportional to the degree of systolic or diastolic blood pressure elevation at any age, in either sex. More than the character of the blood pressure elevation, commonly associated risk factors markedly influence the hazard. The risk of coronary heart disease is concentrated in hypertensives with a high total/high density lipoprotein (HDL) cholesterol ratio, impaired glucose tolerance, high fibrinogen, those with ECG abnormalities and cigarette smokers. Evidence of organ involvement such as left ventricular hypertrophy, proteinuria or impaired left ventricular function are hallmarks of impending cardiovascular sequelae. The presence of ECG-LVH behaves like myocardial infarction in its clinical course, predisposing at the same rate to sudden death, myocardial infarction, cardiac failure and stroke. Consideration of all cardiovascular risk factors is required to evaluate properly the need for treatment, select the best treatment, and set goals and determine the efficacy of treatment. Waiting until there is evidence of organ involvement is dangerous since the first such evidence is often sudden death, a stroke or a myocardial infarction. Optimal treatment must improve the composite risk profile as well as lower the blood pressure. This can be achieved by hygienic (dietary) measures or pharmacological therapy in those who do not respond to diet alteration, weight control and exercise.
W B Kannel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of human hypertension     Volume:  3 Suppl 2     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-02-21     Completed Date:  1990-02-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, MA.
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MeSH Terms
Antihypertensive Agents / adverse effects
Coronary Disease / etiology*,  physiopathology
Hypertension / complications*,  diet therapy,  drug therapy
Lipids / blood
Lipoproteins / blood
Risk Factors
Grant Support
Reg. No./Substance:
0/Antihypertensive Agents; 0/Lipids; 0/Lipoproteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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