Hypertension

  • William J. Kostis
  • Randall M. Zusman
  • Randall M. Zusman
Chapter

Abstract

Hypertension is one of the most common pathologic entities in the world and is associated with the development and exacerbation of a variety of cardiovascular disease, as well as morbid and mortal outcomes. In this chapter, we review the pathophysiology, diagnosis, treatment, and outcomes related to hypertension.

Keywords

Obesity Adenoma Cortisol Proteinuria Vasculitis 

Abbreviations

ACEI

Angiotensin Converting Enzyme inhibitors

ARA

Aldosterone receptor antagonists

ARB

Angiotensin receptor blockers

BB

Beta blockers

BP

Blood pressure

CCB

Calcium channel blockers

CHD

Coronary heart disease

CKD

Chronic kidney disease

CV

Cardiovascular

DBP

Diastolic blood pressure

DM

Diabetes mellitus

HF

Heart failure

ISH

Isolated systolic hypertension

LVH

Left ventricular hypertrophy

LVSD

Left ventricular systolic dysfunction

MI

Myocardial infarction

PA

Primary aldosteronism

PAC

Plasma aldosterone concentration

PAD

Peripheral arterial disease

PRA

Plasma renin activity

PRC

Plasma renin concentration

RAAS

Renin angiotensin aldosterone system

SBP

Systolic blood pressure

WHO

World Health Organization

References

  1.  1.
    Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics—2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:e21–181.PubMedCrossRefGoogle Scholar
  2.  2.
    Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men. The Framingham Heart Study. JAMA. 2002;287:1003–10.PubMedCrossRefGoogle Scholar
  3.  3.
    Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010;303(20):2043–50.PubMedCrossRefGoogle Scholar
  4.  4.
    Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358:1887–98.PubMedCrossRefGoogle Scholar
  5.  5.
    Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the U.S. adult population: results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension. 1995;25:305–13.PubMedCrossRefGoogle Scholar
  6.  6.
    Lawes CMM, Vander Hoorn S, Law MR, Elliott P, MacMahon S, Rodgers A. Blood pressure and the global burden of disease 2000. Part 1: estimates of blood pressure levels. J Hypertens. 2006;24(3):413–22.PubMedCrossRefGoogle Scholar
  7.  7.
    Asmar R. Arterial stiffness and pulse wave velocity: clinical applications. Paris: Elsevier; 1999.Google Scholar
  8.  8.
    Vaitkevicius PV, Fleg JL, Engel JH, et al. Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation. 1993;88:1456–62.PubMedCrossRefGoogle Scholar
  9.  9.
    Celermajer DS, Sorensen KE, Spiegelhalter DJ, et al. Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol. 1994;24:471–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Fleg JL. Effects of aging on the cardiovascular system. In: ACCSAP 6. Washington, D.C.: American College of Cardiology; 2005. p. 6–20.Google Scholar
  11. 11.
    Fotherby MD, Potter JF. Effects of moderate sodium restriction on clinic and twenty-four-hour ambulatory blood pressure in elderly hypertensive subjects. J Hypertens. 1993;11:657–63.PubMedCrossRefGoogle Scholar
  12. 12.
    Beck LH. The aging kidney: defending a delicate balance of fluid and electrolytes. Geriatrics. 2000;55:26–8.PubMedGoogle Scholar
  13. 13.
    Fliser D, Ritz E. Relationship between hypertension and renal function and its therapeutic implications in the elderly. Gerontology. 1998;44:123–31.PubMedCrossRefGoogle Scholar
  14. 14.
    Fried LF, Shlipak MG, Crump C, et al. Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals. J Am Coll Cardiol. 2003;41:1364–72.PubMedCrossRefGoogle Scholar
  15. 15.
    Masaki KH, Schatz IJ, Burchfiel CM, et al. Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program. Circulation. 1998;98:2290–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Levin A, Linas S, Luft FC, et al. Controversies in renal artery stenosis: a review by the American Society of Nephrology Advisory Group on Hypertension. Am J Nephrol. 2007;27:212–20.PubMedCrossRefGoogle Scholar
  17. 17.
    Kendrick J, Chonchol M. Renal artery stenosis and chronic ischemic nephropathy: epidemiology and diagnosis. Adv Chronic Kidney Dis. 2008;15:355–62.PubMedCrossRefGoogle Scholar
  18. 18.
    Pearce JD, Craven BL, Craven TE, et al. Progression of atherosclerotic renovascular disease: a prospective population-based study. J Vasc Surg. 2006;44:955–62.PubMedCrossRefGoogle Scholar
  19. 19.
    Mosso L, Carvajal C, Gonzalez A, et al. Primary aldosteronism and hypertensive disease. Hypertension. 2003;42:161–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Funder JW, Carey RM, Fardella C, et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(9):3266–81.PubMedCrossRefGoogle Scholar
  21. 21.
    Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA. 2000;283:1829–36.PubMedCrossRefGoogle Scholar
  22. 22.
    Bjorkman DJ. The effect of aspirin and nonsteroidal anti-inflammatory drugs on prostaglandins. Am J Med. 1998;105:8S–12.PubMedCrossRefGoogle Scholar
  23. 23.
    Koopmans PP, Thien T, Gribnau FW. The influence of ibuprofen, diclofenac and sulindac on the blood pressure lowering effect of hydrochlorothiazide. Eur J Clin Pharmacol. 1987;31:553–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Parati G, Stergiou GS, Asmar R, et al. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens. 2008;26(8):1505–26.PubMedCrossRefGoogle Scholar
  25. 25.
    Krause T, Lovibond K, Caulfield M, McCormack T, Williams B, Guideline Development Group. Management of hypertension: summary of NICE guidance. BMJ. 2011;343:d4891.PubMedCrossRefGoogle Scholar
  26. 26.
    Franklin SS, Larson MG, Khan SA, et al. Doses the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation. 2001;103(9):1245–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Franklin SS, Khan SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham heart study. Circulation. 1999;100(4):354–60.PubMedCrossRefGoogle Scholar
  28. 28.
    Wong TY, Mitchell P. Hypertensive retinopathy. N Engl J Med. 2004;351:2310–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Held C, Gerstein HC, Yusuf S, et al. Glucose levels predict hospitalization for congestive heart failure in patients at high cardiovascular risk. Circulation. 2007;115:1371–5.PubMedCrossRefGoogle Scholar
  30. 30.
    Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet. 2007;369:201–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Cutler JA, Sorlie PD, Wolz M, et al. Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension. 2008;52:818–27.PubMedCrossRefGoogle Scholar
  32. 32.
    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367:1747–57.PubMedCrossRefGoogle Scholar
  33. 33.
    Flack JM, Neaton J, Grimm Jr R, et al. Blood pressure and mortality among men with prior myocardial infarction. Multiple Risk Factor Intervention Trial Research Group. Circulation. 1995;92(9):2437–45.PubMedCrossRefGoogle Scholar
  34. 34.
    Lewington S, Clareke R, Qizilbash N, Peto R, Collins R. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903–13.PubMedCrossRefGoogle Scholar
  35. 35.
    Jackson R, Lawes CM, Bennett DA, Milne RJ, Rodgers A. Treatment with drugs to lower blood pressure and blood cholesterol based on an individual’s absolute cardiovascular risk. Lancet. 2005;365(9457):434–41.PubMedGoogle Scholar
  36. 36.
    Hu BH. Diet and exercise for new-onset type 2 diabetes. Lancet. 2011;387:101–2.CrossRefGoogle Scholar
  37. 37.
    Opie LH. Glycemia and heart failure in diabetes types 1 and 2. Lancet. 2011;387:103–4.CrossRefGoogle Scholar
  38. 38.
    Booth GL, Kapral MK, Fung K, Tu JV. Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study. Lancet. 2006;368:29–36.PubMedCrossRefGoogle Scholar
  39. 39.
    Jessup M, Brozena S. Heart failure. N Engl J Med. 2003;348:2007–18.PubMedCrossRefGoogle Scholar
  40. 40.
    Kostis JB, Davis BR, Cutler J, et al. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. JAMA. 1997;278:212–6.PubMedCrossRefGoogle Scholar
  41. 41.
    Kostis JB, Lawrence-Nelson J, Ranjan R, Wilson AC, Kostis WJ, Lacy CR. Association of increased pulse pressure with the development of heart failure in SHEP. Am J Hypertens. 2001;14(8):798–803.PubMedCrossRefGoogle Scholar
  42. 42.
    Gottdiener JS, McClelland RL, Marshall R, et al. Outcome of congestive heart failure in elderly persons: influence of left ventricular systolic function. The Cardiovascular Health Study. Ann Intern Med. 2002;137:631–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 report. JAMA. 2003;289:2560–72.PubMedCrossRefGoogle Scholar
  44. 44.
    Mancia G, De Backer G, Dominiczak A, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension. J Hypertens. 2007;25(9):1751–62.PubMedCrossRefGoogle Scholar
  45. 45.
    Whelton PK, Appel LJ, Espeland MA, et al. Efficacy of sodium reduction and weight loss in the treatment of hypertension in older persons: main results of the randomized, controlled trial of nonpharmacologic interventions in the elderly. JAMA. 1998;279:839–46.PubMedCrossRefGoogle Scholar
  46. 46.
    Kostis JB, Wilson AC, Shindler DM, Cosgrove NM, Lacy CR. Persistence of normotension after discontinuation of lifestyle intervention in the trial of TONE. Am J Hypertens. 2002;15:732–4.PubMedCrossRefGoogle Scholar
  47. 47.
    Turnbull F, Blood Pressure Lowering Treatment Trialists’ Collaboration, et al. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527–35.PubMedCrossRefGoogle Scholar
  48. 48.
    Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med. 1999;130:461–70.PubMedCrossRefGoogle Scholar
  49. 49.
    Whelton PK, Barzilay J, Cushman WC, et al. Clinical outcomes in antihypertensive treatment of Type 2 diabetes, impaired fasting glucose concentration, and normoglycemia. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Arch Intern Med. 2005;165:1401–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Kostis JB, Wilson AC, Freudenberger RS, Cosgrove NM, Pressel SL, Davis BR, et al. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. Am J Cardiol. 2005;95:29–35.PubMedCrossRefGoogle Scholar
  51. 51.
    Swislocki AL, Hoffman BB, Reaven GM. Insulin resistance, glucose intolerance and hyperinsulinemia in patients with hypertension. Am J Hypertens. 1989;2:419–23.PubMedGoogle Scholar
  52. 52.
    Siegel D, Saliba P, Haffner S. Glucose and insulin levels during diuretic therapy in hypertensive men. Hypertension. 1994;23:688–94.PubMedCrossRefGoogle Scholar
  53. 53.
    Choi HK, Atkinson K, Karlson EW, et al. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med. 2005;165:742–8.PubMedCrossRefGoogle Scholar
  54. 54.
    Aronow WS, Fleg JL, Pepine CJ, et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2011;57(20):2037–114.PubMedCrossRefGoogle Scholar
  55. 55.
    Kostis JB, Breazna A, Deedwania PC, LaRosa JC. The benefits of intensive lipid lowering in patients with stable coronary heart disease with normal or high systolic blood pressure: an analysis of the Treating to New Targets (TNT) Study. J Clin Hypertens. 2008;10:367–76.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • William J. Kostis
    • 1
  • Randall M. Zusman
    • 2
  • Randall M. Zusman
    • 3
  1. 1.Harvard Medical School Cardiology Division, Department of MedicineMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Hypertension, Cardiology Division, Department of MedicineMassachusetts General HospitalBostonUSA

Personalised recommendations