PREVENTIVE MEDICINE and HEALTH PROMOTION Hypertension

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Preventive Medicine & Health Promotion: Fourth Year Elective
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HYPERTENSION

Primary Prevention

Benefits of Prevention

  • 30 – 40% average stroke reduction
     
  • 20 – 25% average myocardial infarction reduction
     
  • more than 50% average heart failure reduction

“The prevalence of hypertension will increase even further unless broad and effective preventive measures are implemented.”

Lifestyle modification:

Primary prevention

Therapy

In addition to medication treatment for all hypertensive patients

In patients with stage 1 hypertension (SBP 140-159 mm Hg and/or DBP 90-99 mm Hg) and additional cardiovascular risk factors, achieving a sustained 12 mm Hg reduction in SBP over 10 years will prevent 1 death for every 11 patients treated.  In the presence of CVD or target organ damage, only 9 patients would require such BP reduction to prevent a death.9

  • Treatment of hypertension has not been shown to be 100% effective; persons treated with “tight” hypertension control do not reach normotensive levels.
     
  • Even if adequately treated according to current standards, patients with hypertension may not achieve “normal” levels. 
     
  • Many persons do not make adequate lifestyle changes or take enough medications to control hypertension.
     
  • A significant portion of cardiovascular disease occurs in people whose blood pressure is above the optimal level (120/80 mm Hg) but not so high as to be diagnosed or treated as hypertension.  A population wide approach to lowering of blood pressure can reduce this considerable burden of risk.
     
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