Hypertension: blood pressure should be reduced immediately if evidence of end-organ damage.

The study

The evidence

• In hypertensive emergencies, require blood pressure to be reduced immediately to prevent or limit target organ damage. In hypertensive urgencies, it is desirable to reduce blood pressure within a few hours.
• Hypertension awareness, treatment and control rates have increased during the past three decades.
• Age-adjusted mortality rates for stroke and CHD declined during this time, but are now leveling.
• End-stage renal disease and prevalence of heart failure are increasing.
• Prevention and treatment of hypertension and target organ disease remain important public health issues.
• A significant proportion of cardiovascular disease occurs in people whose blood pressure is above the optimal level (120/ 80 mmHg) but not so high as to be diagnosed or treated as hypertension.
• lifestyle modifications:
  • lose weight if overweight
  • limit alcohol intake to no more than 30 ml of ethanol per day, or 15 ml per day for women, and lighter-weight people
  • increase aerobic physical activity (30-45 mins most days of the week)
  • reduce sodium intake to no more than 100 mmol/d
  • maintain adequate intake of dietary potassium (~90 mmol/d), calcium and magnesium
  • stop smoking and reduce intake of saturated fat and cholesterol

Comments

1. National guidelines for hypertension.
2. This is a source used for bibliographic reference and 'expert opinion'

Citation

1. , : The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Archives of Internal Medicine 1997; 157: 2413-2446