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Blood Pressure and Hypertension Management

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ASPC Manual of Preventive Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

The prevention and management of hypertension remains a significant public health problem. The recent recommendations for the management of high blood pressure by the American College of Cardiology/American Heart Association (ACC/AHA) have redefined hypertension at a blood pressure of 130/80 mmHg or greater. Blood pressure management requires an understanding of both non-pharmacologic and pharmacologic interventions, as well as the major cardiovascular disease (CVD) risk factors. The recommended approach to treating blood pressure in patients with hypertension starts with the appropriate measurement of blood pressure, with an increased emphasis on home and ambulatory monitoring. This is followed by blood pressure staging and if Stage 1 (130–139/80–89 mmHg) or Stage 2 (≥140/90 mmHg), and then the initiation of nonpharmacologic interventions such as smoking cessation in tobacco users, a vegetable-rich diet, daily walking and/or exercise three times a week, and other healthy lifestyle strategies. For those with a blood pressure of ≥130/80 mmHg who have a 10-year atherosclerotic CV disease (ASCVD) risk of ≥10%, the initiation of pharmacologic therapy is recommended with a target blood pressure of <130/80 mmHg for most adults. This risk level captures the majority of people with hypertension who could benefit from pharmacologic therapy. Optimal blood pressure control necessitates an appropriate sensitivity to and an understanding of demographic, socio-cultural, and other factors that may act as barriers to a recommended care plan and promotion of adherence to not only improve blood pressure control but to address cardiovascular risk factors to reduce premature morbidity and mortality.

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Acknowledgments

This work was supported in part by National Institutes of Health grants P30AG021684 (KN), UL1TR000124 (KN), HHSN26818HV00009R (KN and BB), and R25HL126145 (KN and BB). The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Keith C. Norris

  2. Department of Health Systems and Population Health Science, College of Medicine, University of Houston, Houston, TX, USA

    Bettina M. Beech

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  1. Keith C. Norris
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Correspondence to Keith C. Norris .

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Editors and Affiliations

  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA

    Nathan D. Wong

  2. Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, USA

    Ezra A. Amsterdam

  3. Cicarrone Center for the Prevention of Cardiovascular Disease, John Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Norris, K.C., Beech, B.M. (2021). Blood Pressure and Hypertension Management. In: Wong, N.D., Amsterdam, E.A., Toth, P.P. (eds) ASPC Manual of Preventive Cardiology. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-56279-3_11

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