Hypertension
Hypertension is a pathological condition characterized by high blood pressure values.
The overall prevalence of hypertension in adults is around 30-45%. Hypertension becomes progressively more common with advancing age, with a prevalence of more than 60% in people aged more than 60 years.
Elevated blood pressure (BP) values, both office BP and out-of-office BP, are related to an increased incidence of major cardiovascular events (ischemic and haemorrhagic stroke, myocardial infarction, renal insufficiency, peripheral arterial disease, atrial fibrillation and dementia)
and for this reason prompt diagnosis and treatment are important.
This condition is often associated with:
- pathological metabolic conditions (i.e. dyslipidemia, diabetes mellitus)
- unhealthy lifestyles (i.e. sodium salt abuse, smoking, alcoholism, stress, sedentary lifestyle)
- familiarity and obesity
These associations exponentially increase the cardiovascular risk.
Therefore, the evaluation of a patient with arterial hypertension is also aimed at identifying these conditions and their treatment.
n accordance with most major guidelines it is recommended that hypertension be diagnosed when a person’s systolic blood pressure (SBP) in the office or clinic is ≥140 mmHg and/or their diastolic blood pressure (DBP) is ≥90 mmHg following repeated examination.
This is the classification of office blood pressure (mmHg):
- Optimal 110 < SBP < 120 and 70 < DBP < 80
- Normal 120 < SBP < 129 and/or 80 < DBP < 84
- High normal 130 < SBP < 139 and/or 85 < DBP < 89
- Grade 1 hypertension 140 < SBP < 159 and/or 90 < DBP < 99
- Grade 2 hypertension 160 < SBP < 179 and/or 100 < DBP < 109
- Grade 3 hypertension SBP ≥180 and/or DBP ≥110
- Isolated systolic hypertension SBP ≥140 and DBP <90
The pathophysiological classification is:
- idiopathic or primary in which no determining cause is identified (85-95% of cases)
- secondary in which a determining cause is identified (5-15% of cases)
Secondary forms include obstructive sleep apnoea, renal and reno-vascular disease, endocrine causes (primary aldosteronism, pheochromocytoma, thyroid disease, Cushing's syndrome, hyperparathyroidism) and other rare forms (i.e. coarctation of the aorta).
Arterial hypertension can occur in a totally asymptomatic manner and appear with its complications in target organs (eg brain, heart, vessels and kidney) or give aspecific symptoms:
- Central nervous system: headache, impaired vision, dizziness, syncope etc.
- Cardiovascular system: angina pectoris, shortness of breath, reduced exercise tolerance, claudication intermittens.
- Urinary system: nocturia (the need to urinate at night two or more times), polyuria (increased frequency of urination).
ProKardia, through a team of specialists, offers an assistance aimed to ensure:
- Risk-group screening
- Diagnosis and monitoring
- Cardiovascular risk stratification
- Therapeutic management and prevention
Reference: European Heart Journal (2016) 37, 67–119