Health Risks Associated with Hypertension

Hypertension is a risk factor for two of the three leading causes of death in the United States, Heart Disease and Stroke.

• Risk factors for hypertension are also risk factors for cardiovascular disease and stroke, dyslipidemia, diabetes, and CHD mortality (ref CHD and stroke deaths chart – CDC, also prevalence of risk factors for heart disease and stroke chart)

  • Leading causes of death 1997: heart disease – 31.4%, stroke 6.9%, chronic obstructive pulmonary disease 4.7%, diabetes 2.7% kidney disease 1.1%
     
  • 1^st, 2^nd, 3^rd leading causes of death in age group >65 is heart disease, cancer, stroke. (ref chart for the prevalence of contributors – hypertension, coronary heart disease, stroke, rheumatic heart disease also leading cause of death table by sex, age, race)
     
  • Third leading cause of death in 25 – 44 age group is heart disease.  Second leading cause of death in age group 45 to 64 is heart disease.

• Hypertension is the most common precursor to cardiovascular disease and stroke.
   
• The relationship between hypertension and cardiovascular disease is “strong, continuous, graded, consistent, independent, predictive, and etiologically significant for those with and without coronary heart disease (CHD)”
   
• There is no convincing evidence for a J curve or threshold value below which the risk for cardiovascular and renal disease does not exist.
   
• The observed association of risk is stronger for systolic blood pressure than the corresponding diastolic blood pressure.
   
• In one recent report, low risk individuals (non-smokers, serum cholesterol <200mg/dL [5.18mmol/L, blood pressure £ 120/80 mmHg) have 72 – 85% lower cardiovascular disease mortality and 40 – 59% lower all cause mortality when compared to persons with at least one of the three mentioned risk factors. 

 
• End Stage Renal disease
   
• “For individuals 40 – 70 years of age, each increment of 20 mm Hg in systolic BP (SBP) or 10 mm Hg in diastolic BP (DBP) doubles the risk of CVD across the entire BP range from 115/75 to 185/115 mm Hg.”

One half of the decline seen in death rates from stroke in white women and 2/3 of the decline seen in African American women can be attributed to a decline in blood pressure

• Dramatic improvements have slowed in recent years and the age adjusted stroke rates have risen slightly and the slope of the age adjusted rate of decline in CHD appears to be leveling
   
• Rates for end stage renal disease have increased, high blood pressure is the most common antecedent to ESRD
   
• Prevalence of heart failure has also increased, for which hypertension is the most common precursor.
   
• Hypertension control rates have not continued to improve.
   
• If trends in the awareness, treatment and control established between 1976 – 1980 and 1988 – 1991, continued, in 1994 the awareness would have been 76.2%, treatment 59.6%, control 31.2%.