Epidemiology of Hypertension
How is blood pressure classified?
In order to determine who needs to be treated a classification of normal and abnormal has been developed. These blood pressure ranges are based on a risk assessment of long-term harm. The classification described here is used in the U.S. however there is a similar European classification.
Blood pressure measurements are typically written with the systolic pressure on top and the diastolic pressure on the bottom; for example 120/80. The systolic pressure is the pressure in the arteries measured at the time of the heart contraction (heart beat) and the diastolic at the time of heart relaxation or between beats when the heart is refilling with blood.
Normal blood pressure is a systolic of less than 120 and a diastolic pressure less than 80. Pre-hypertension is a blood pressure of 120-139/80-89. Stage 1 hypertension occurs when the blood pressure is 140-159/90-99 while Stage 2 occurs when the pressure is 160/100 or higher. This classification is helpful in determining treatment recommendations.
Why is hypertension a big deal?
Untreated, long standing hypertension can lead to many problems. Since the heart has to work harder to pump blood through the arteries, the heart will hypertrophy over time, eventually failing. The enlarged heart is also prone to developing abnormal rhythms, which could result in sudden death. Hypertension to lead to myocardial infarction (MI), also known as heart attack, in those with coronary artery disease. Hypertension can lead to stroke and kidney failure. All of these consequences are even more likely to occur in the setting of other problems such as diabetes or atherosclerosis.
Who gets Hypertension?
Age is the major risk factor in developing hypertension. The older we get, the more likely we are to develop high blood pressure. It is present in the majority of people over 65 years of age. Race is another major risk factor. It is more prevalent in African Americans. Other factors include obesity, sedentary lifestyle, family history, elevated blood lipids, excessive salt intake and excessive alcohol use.
Why isn’t everyone treated?
Many people have heard of high blood pressure or at least know of someone being treated but not many truly understand the potential grave consequences of being untreated or inadequately treated. One study reported estimated that 50% of those treated are not adequately controlled. The numbers of those who are untreated is unclear but is most certainly staggering.
There are many reasons why this is occurring. Obviously lack of understanding of the consequences. For many the lack of symptoms leads to significant problems with compliance. This is where health education and literacy may play a role. In other cases it is due to poor access to health care and the inability to pay for the required medication. This is a social issue that the U.S. continues to struggle with but there maybe significant improvement in access once the Affordable Care Act is fully implemented.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!
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