Article

Expanding the Definition and Classification of Hypertension

Louisiana State University School of Medicine, New Orleans, LA 70112, USA.
Journal of Clinical Hypertension (Impact Factor: 2.85). 10/2005; 7(9):505-12. DOI: 10.1111/j.1524-6175.2005.04769.x
Source: PubMed

ABSTRACT

Cardiovascular abnormalities are frequently the cause, as well as the effect, of elevated blood pressure. As such, early cardiovascular disease (CVD) may be established before identifiable blood pressure thresholds are crossed. To identify individuals at risk for CVD at an earlier point in the disease process, as well as to avoid labeling persons as hypertensive who are at low risk for CVD, the Hypertension Writing Group proposes incorporating the presence or absence of cardiovascular risk factors, early disease markers, and target organ damage into the definition and classification scheme of hypertension. To describe both the complexity and progressive nature of hypertension, the following definition is proposed: "Hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. Early markers of the syndrome are often present before blood pressure elevation is observed; therefore, hypertension cannot be classified solely by discrete blood pressure thresholds. Progression is strongly associated with functional and structural cardiac and vascular abnormalities that damage the heart, kidneys, brain, vasculature, and other organs and lead to premature morbidity and death." Classification of hypertension must involve assessing global cardiovascular risk to situate an individual's risk for CVD and events along a continuum. As knowledge of early CVD continues to evolve, the approach to classifying individuals along that continuum can be expected to evolve accordingly. The four categories currently used to classify hypertension are normal, prehypertension, and stages 1 and 2 hypertension. The population identified with prehypertension includes a subgroup with early CVD. We believe it would be preferable to classify all individuals as either normal or hypertensive, based on their cardiovascular evaluation, using the four categories of normal and stages 1, 2, and 3 hypertension.

Full-text preview

Available from: newlinemedical.com
  • Source
    • "All these experimental evidences reveal the stretch linkage between aging and hypertension. Recently, a brilliant article performed by the American Society of Hypertension Writing Group [26] recognized the pivotal role of vascular aging in the continuum of cardiovascular risk leading to hypertension. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Hypertension is a widely prevalent and important risk factor for cardiovascular diseases that increase with aging. The hallmark of hypertension in the elderly is increased vascular dysfunction. However, the molecular mechanisms by which increased blood pressure leads to vascular injury and impaired endothelial function are not well defined. In the present paper, we will analyze several mechanisms described in the scientific literature involved in hypertension in the elderly as endothelial dysfunction, increased oxygen delivery to tissues, inflammation, cellular apoptosis, and increased concentration of active metabolites. Also, we will focus on new molecular mechanisms involved in hypertension such as telomeres shortening, progenitor cells, circulating microparticles, and epigenetic factors that have appeared as possible causes of hypertension in the elderly. These molecular mechanisms may elucidate different origin for hypertension in the elderly and provide us with new targets for hypertension treatment.
    Full-text · Article · Jan 2012
  • Source
    • "Approximately 25% of the adult populations are affected. Although historically defined as " an elevation of blood pressure " alone, hypertension is characterized by abnormalities of cardiac output, systemic vascular resistance, and arterial compliance (Giles et al., 2005). "

    Full-text · Article · Oct 2010
  • Source
    • "Approximately 25% of the adult populations are affected. Although historically defined as " an elevation of blood pressure " alone, hypertension is characterized by abnormalities of cardiac output, systemic vascular resistance, and arterial compliance (Giles et al., 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: An attempt was made to study the role of lipid profile serum Mg+2, and blood glucose in hypertension individuals.Moreover, all the parameters are analyzed biochemically. In about 80 samples (50cases and 30 controls) and it isobserved that dyslipidemia is seen in Hypertensive individuals with no change in HDL concentration. There is nocorrelation of serum magnesium in hypertensive cases with controls. It has been observed that serum magnesium ofhypertensive cases is slightly higher than that of normal individuals. Fasting blood glucose of hypertensive cases(101.62mg/dl ±33.78) is higher than that of Controls (82.46 mg/dl±10.8). This increase is statistically significant(p<0.001). But this increase may be due to the presence 12% diabetic cases present in the cases. Even then, there isa tendency of developing impaired glucose tolerance in hypertensive subjects. The blood pressure is notedseparately as systolic blood pressure and diastolic blood pressures. The systolic blood pressure was more significantthan the diastolic blood pressure with increasing age groups.
    Preview · Article · Jan 2010
Show more