PA and Hypertension

PA and Hypertension - PA and Hypertension Hypertension...

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PA and Hypertension Hypertension diagnosis ( Joint National Cmtee 2003) ≥100 ≥160 Stage 2 Hypertension 90-99 140-159 Stage 1 Hypertension 80-89 120-139 Prehypertension <80 <120 Normal Diastolic (mmHg) Systolic (mmHg) Category • …or taking antihypertension drug Previous classification of HT Primary/Essential Hypertension • 90-95% of cases of chronically elevated systemic arterial pressure • Unknown or unpredictable cause • Left ventricular hypertrophy • 3/4 of all primary is mild • 1/4 is severe Magnitude of the Problem • NHANES III – Declined 1960-1991 – Increased 1991-2000: 25% -> 29% – NCHS 1997: 50 million Americans – Today: 20% of American adults (43 million) • Framingham Heart Study (30-y prospective) – Declined 2/3 in past 40 y – 2/3 of 45- to 54-y-olds developed HT • Age and race connection (Dishman fig. 6.1) • Antihypertension meds – $15.5 of $37 billion total annual burden The Growing Burden of Heart Disease and Stroke in Canada 2003 Figure 1-20 Percentage of the general population aged 20+ years who reported having high blood pressure, Canada, 1994-2000 13.2 14.2 15.4 15.7 10.0 11.5 11.9 13.0 11.6 12.9 13.7 14.4 0 5 10 15 20 1994 1996 1998 2000 Year Percent Women Men Both Source: Statistics Canada, National Population Health Survey and Canadian Community Health Survey. The Growing Burden of Heart Disease and Stroke in Canada 200 Figure 1-21 Percentage of the general population aged 20+ years who reported having high blood pressure by age group and sex, Canada, 2000 2.0 3.5 8.8 21.6 33.4 44.9 1.7 4.5 9.6 18.5 29.9 34.8 0 10 20 30 40 50 20-29 30-39 40-49 50-59 60-69 70+ Age Group (years) Women Men Source: Statistics Canada, Canadian Community Health Survey
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Systolic blood pressure and cardiovascular mortality Systolic blood pressure <110 110-119 120-129 130-139 140-149 150-159 >160 % OF MEN 0 5 10 15 20 25 Adjusted relative risk 1 2 3 4 5 Percentage Adjusted relative risk Nieman Heart Disease, Figure 10.25 <112 112-117 118-120 121-124 125-128 129-131 132-136 137-141 142-150 >151 Systolic blood pressure Risk for stroke 0 1 2 3 4 5 6 7 8 9 10 Systolic blood pressure and stroke mortality Nieman Heart Disease, Figure 10.27 Drug treatment • Drugs have been fairly successful in managing HT & reducing mortality – Not in white women in some studies – Serious side effects of various meds • X: Incidence of MI and strokes by 25% • Y: Heart failure by 38% • Z: Stroke by 15% and heart failure by 19% – BP 160/100, cholesterol 240 mg%, & HDL 40 mg% - 32% chance of CHD within 12 years • Diuretics - lower BP but elevate cholesterol 15 mg%
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This note was uploaded on 08/13/2008 for the course EDKP 330 taught by Professor Koziris during the Fall '07 term at McGill.

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PA and Hypertension - PA and Hypertension Hypertension...

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