Korean Circ J.  2020 Jun;50(6):469-475. 10.4070/kcj.2020.0067.

A 2020 Vision of Hypertension

• Cheung BM
• Or B
• Fei Y
• Tsoi MF

• KMID: 2500914
• DOI: http://doi.org/10.4070/kcj.2020.0067

Abstract

Hypertension is a common chronic disease affecting a large section of the general population. Hypertension is highly prevalent in the elderly because blood pressure (BP) rises with age. The risk of developing hypertension increases with predisposing genes, intrauterine growth retardation, prematurity and childhood obesity. BP is easier to control in the young. Non-pharmacological treatment through lifestyle changes, such as weight control and leisure-time physical activity, is more likely to be successful in young people. Hypertension in older adults is more difficult to control, requiring the use of more than one antihypertensive drug. Adverse effects and compliance become problematic. Much research is now directed at novel ways of controlling BP such as denervation. The change in definition of hypertension in the American guideline highlights the need to identify and manage hypertension early, at a stage when it is potentially reversible.

Keyword

Hypertension; Blood pressure; Guideline

Figure

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  Figure 1 Relationship between SBP and body mass index in children in US NHANES 2011–2012. Children aged 8–11, 12–15, and 16–19 years are represented by circles, triangles and squares respectively. The regression lines are shown as solid, dashed and dotted lines respectively.NHANES = National Health and Nutrition Examination Survey; SBP = systolic blood pressure.

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  Figure 2 Kaplan-Meier plot showing the survival curves of US NHANES participants with different levels of BP at baseline. Participants were categorized as normal BP (SBP <120 mmHg and DBP <80 mmHg); elevated BP (SBP 120–129 mmHg and DBP <80 mmHg); stage 1 HT (SBP 130–139 mmHg or DBP 80–89 mmHg); or stage 2 HT (SBP ≥140 mmHg or DBP ≥90 mmHg). Note the curves for elevated BP and stage 1 HT are superimposable and therefore shown as one curve.BP = blood pressure; DBP = diastolic blood pressure; HT = hypertension; NHANES = National Health and Nutrition Examination Survey; SBP = systolic blood pressure.

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  Figure 3 Kaplan-Meier plot showing the survival curves of each PA group for US NHANES participants aged 18 to 64 years old at baseline. Participants were categorized into groups by their weekly amount of LTPA, OPA, and the tPA. Values for PA are in minutes/week. The groups with LTPA ≥150 minutes/week had higher survival when compared with the group with no PA (all p<0.001).LTPA = leisure-time physical activity; NHANES = National Health and Nutrition Examination Survey; OPA = occupational physical activity; PA = physical activity; tPA = total physical activity.

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