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Raised blood pressure as a risk factor for chronic disease

Introduction

The questions in this module measure: History of raised blood pressure Repeated systolic and diastolic blood pressure

Research findings

Some research findings related to raised blood pressure are as follows: Worldwide, raised blood pressure is estimated to cause 7.1 million deaths, about 13% of the total. This accounts for 64.3 million DALYs or 4.4% of the total.1 Raised blood pressure is a major risk factor for coronary heart disease and ischemic as well as hemorrhagic stroke.2 Blood pressure levels have been shown to be positively and continuously related to the risk of stroke and coronary heart disease.3 The risk of cardiovascular disease doubles for each increment of 20/10 mm Hg of blood pressure, starting as low as 115/75.4 Complications of raised blood pressure include heart failure, peripheral vascular disease, renal impairment, fundal hemorrhages, and papillodema.5 Treating systolic blood pressure and diastolic blood pressure to targets that are less than 140/90 is associated with a decrease in cardiovascular complications.3 Stage 1/Grade 1 hypertension, is defined in a clinical setting when the mean blood pressure is equal to or above 140/90 and less than 160/100 on two or more measurements on each of two or more visits on separate days.3,4,5 Stage 2/Grade 2 hypertension is defined in a clinical setting when the mean blood pressure is equal to or more than 160/100 and less than 180/110 on two or more measurements on each of two or more visits on separate days.3,4,5 Stage 3/Grade 3 hypertension is defined in a clinical setting when the mean blood pressure is equal to or more than 180/110 during two or more measurements on each of two or more visits on separate days.3,4,5

Reference

1. The World Health Report 2002. Reducing risks, promoting healthy life. World Health Organization, Geneva, 2002. 2. Diet, nutrition and the prevention of chronic diseases. Report of a joint WHO/FAO expert consultation. World Health Organization, Geneva, 2003. 3. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. Journal of Hypertension 2003; 21: 1983-1992. 4. Chobanian A V, Bakris G L, Black H R et al. The Seventh Report of the National Committee on Prevention, Detection, Evaluation, and Treatment of high blood pressure. Journal of American Medical Association, 2003;

289(19): 1206-1252. 5. Williams B, Poulter N R, Brown M J et al. British Hypertension Society guidelines for hypertension management 2004 (BHS IV): summary. British Medical Journal, 2004; 328: 634-640.

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