Hypertension

188 Pages·2012·0.727 MB·English

by  Bakris, George L., Baliga, R. R

O A C L
OXFORD AMERICAN CARDIOLOGY LIBRARY
Hypertension
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O A C L
OXFORD AMERICAN CARDIOLOGY LIBRARY
Hypertension
George Bakris, MD, DMSc(Hon), FASH, FASN
Professor of Medicine
Director, Hypertension Center
University of Chicago Pritzker School of Medicine
Chicago, IL
Ragavendra R. Baliga, MD, MBA, FACP,
FRCP (Edin), FACC
Editor-in-Chief, Heart Failure Clinics of North America
Associate Editor, Am Coll of Cardiology
Cardiosource Journal Scan
Vice Chief & Asst Division Director
Division of Cardiovascular Medicine
Professor of Internal Medicine
The Ohio State University Medical Center
Columbus, OH
1
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Library of Congress Cataloging-in-Publication Data
Hypertension / [edited by] George Bakris, Ragavendra R. Baliga.
p. ; cm. — (Oxford American cardiology library)
Includes bibliographical references and index.
ISBN 978-0-19-975490-8 (pbk. : alk. paper)
I. Bakris, George L., 1952- II. Baliga, R. R. III. Series: Oxford American cardiology
library.
[DNLM: 1. Hypertension. WG 340]
616.132—dc23 2011039915
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
Disclosures
Dr. Bakris has received investigator initiated grants for clinical studies
from Forest Labs, CVRx, Novartis, Relapsya and Medtronic. He has
served as a consultant for Takeda, Abbott, Walgreen’s, CVRx, Johnson &
Johnson, and Servier.
Dr. Baliga has served on the Speakers Bureau for Boehringer-Ingelheim,
GlaxoSmithKline, Pfi zer, Reliant Pharmaceuticals, Merck-Schering Plough/
Merck, AstraZeneca, and Otsuka. He has also received consultant fees/
honoraria from Mardil.
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Preface
More than 75 million Americans age 18 and older have hypertension and
individuals who are normotensive at age 55 have a 90% lifetime risk for
developing high blood pressure. Hypertension is the leading risk factor
for stroke and cardiovascular disease. In individuals over the age of 50, sys-
tolic blood pressure is a more important than diastolic blood pressure as
a risk factor for cardiovascular disease. Starting at 115/75 mm Hg, cardio-
vascular risk doubles with each increment of 20/10 mm Hg throughout the
BP range. Therefore, those health-promoting lifestyle modifi cations help
delay the development of cardiovascular disease and onset of hyperten-
sion. Reducing blood pressure can reduce stroke incidence by as much as
35–40%, the incidence of myocardial infarction by 20–25% and incidence of
heart failure by 50%. With growing obesity epidemic hypertension preva-
lence will continue to grow as will diabetes. Together these diseases will be
the leading causes of cardiovascular morbidity and mortality.
We invited an international group of experts to discuss and share their vii
expertise regarding hypertension and its contribution to cardiovascular risk
and updated opportunities to modify this risk. The authors are leaders in
their fi eld and share insights regarding new fi ndings as they apply to clinical
practice in their respective areas of research. We, therefore, hope that this
book will serve as an informative and stimulating, up-to-date state-of-the
art overview that will assist internists, primary care physicians, physician-
extenders and specialists improve blood pressure control rates and reduce
morbidity.
George Bakris, MD, DMSc(Hon), FASH, FASN
Professor of Medicine
Director, Hypertension Center
University of Chicago Pritzker School of Medicine
Chicago, IL
Ragavendra R. Baliga, MD, MBA, FACP (Edin), FACC,
Editor-in-Chief, Heart Failure Clinics of North America
Associate Editor, Am Coll of Cardiology
Cardiosource Journal Scan
Vice Chief & Asst Division Director
Division of Cardiovascular Medicine
Professor of Internal Medicine
The Ohio State University Medical Center
Columbus, OH
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Contents
Contributors xi
1 Impact of High Blood Pressure on Cardiovascular
Risk and Benefi ts of Lowering Blood Pressure 1
2 Diagnosing Hypertension 15
3 Laboratory and Diagnostic Procedures 29
4 Treatment of Essential Hypertension 39
5 Managing Comorbidities
a. Ischemic Heart Disease 55
b. Heart Failure 59
c. Diabetic Hypertension 65
d. Chronic Kidney Disease 71
e. Cerebrovascular Disease/Cognitive Function 83
6 Special Populations
a. Hypertensive Urgencies and Emergencies 93
b. Minorities 99
c. Hypertension in Pregnancy 105
d. Hypertension in Children and Adolescents 117
e. Obesity and the Metabolic Syndrome 123
f. Peripheral Arterial Disease 135
7 Improving Hypertension Control
a. Adherence to Regimens 143
b. Resistant Hypertension 151
8 Public Health Challenges and Community Programs 157
Appendix 163
Index 167