Cardiovasc Prev Pharmacother.  2020 Apr;2(2):33-42. 10.36011/cpp.2020.2.e8.

Shifting from Pharmacotherapy to Prevention of Hypertension

• Cheung BMY
• Tsoi MF

• KMID: 2536972
• DOI: http://doi.org/10.36011/cpp.2020.2.e8

Abstract

Hypertension is a common chronic disease affecting a large section of the general population. As hypertension is usually asymptomatic, awareness, treatment and control rates are low. Drug side-effects also affect compliance. Hypotension and electrolyte abnormalities in the elderly can be severe. Therefore, prevention is better than cure. As blood pressure rises with age, prevention should be started early. As there are many genes affecting blood pressure, genetic tests are not useful. Good antenatal care and care of preterm infants can help to prevent adult cardiovascular diseases including hypertension. Childhood obesity is an important determinant of blood pressure in childhood and adolescence. This is a window of opportunity for prevention. The current American College of Cardiology/American Heart Association guideline on hypertension defines stage 1 hypertension as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. Although this makes many people in the general population hypertensive, stage 1 hypertension in young adults is already associated with increased cardiovascular and mortality risk. Fortunately, hypertension at this early stage is easy to control and weight loss is easier in young males, who can get exercise from work or exercise after work. Leisure-time physical activity seems more beneficial than occupational physical activity. Cardiovascular risk assessment and promoting a healthy lifestyle in the young are likely to forestall hypertension and future cardiovascular disease. Preventing or reversing hypertension is no longer an impossible dream.

Keyword

Hypertension; Drug therapy; Essential hypertension; Prehypertension; Primary prevention; Secondary prevention

Figure

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  Figure 1. Relationship of systolic blood pressure with BMI and waist circumference.BMI = body mass index; SBP = systolic blood pressure.

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  Figure 2. Data on 3,653 boys and 3,697 girls from National Health and Nutrition Examination Survey 2007–2008 are shown.19)The blood pressures of boys and girls are represented by filled squares and open circles, respectively. The regression lines for boys and girls are shown as full and broken lines.SBP = systolic blood pressure.

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