Number of patients with hypertension worldwide

According to the Global Hypertension Report released by WHO, the number of patients with hypertension (blood pressure of 140/90 mmHg or higher or taking hypertension medication) doubled from 650 million to 1.3 billion between 1990 and 2019.

Global impact of hypertension

Hypertension affects one-third of adults worldwide. Data from 2019 showed that among adults aged 30 to 79, the number of people with hypertension in the Eastern Mediterranean region was approximately 99 million, 346 million in the Western Pacific region, 106 million in Africa, 197 million in the Americas, 230 million in Europe, and 294 million in Southeast Asia.

Diagnosis and treatment

Among hypertensive patients aged 30 to 79, only 54% were diagnosed with hypertension, 42% received hypertension treatment, and 21% were under control. This means that nearly half of patients with hypertension are unaware of their condition, and about 80% fail to receive adequate treatment.

Causes of Disease

The cause of hypertension is unclear, and more attention is paid to its risk factors, including genetic factors, age, and unhealthy lifestyles. Among them, 70%-80% of hypertension is related to unhealthy lifestyles. As the risk factors for hypertension gather, the risk of hypertension will increase.

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Symptoms of hypertension

Many hypertensive patients have other asymptomatic diseases without feeling any discomfort. This is usually called target organ damage, so hypertension is called the "silent killer". Hypertension sometimes has some less specific symptoms, such as headache, paroxysmal dizziness, chest tightness, numbness of the limbs, etc. At this time, patients and doctors should be alert to whether it is a sign of early hypertension.

Symptoms of hypertension

Different subtypes of hypertension have their special symptoms:

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  • - Gestational hypertension is induced by pregnancy, and the main symptoms are proteinuria and edema. In severe cases, convulsions, coma, and even death may occur.
  • - Infants and young children with hypertension may be irritable, overexcited, screaming at night, and have slow growth and development, etc.
  • - Menopausal hypertension can manifest as soreness in the waist and knees, edema in the limbs, etc.

When combined with other symptoms, the clinical manifestations of hypertension are more complicated. There are many common complications of hypertension, which will have related symptoms.

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Medical diagnosis of hypertension

Judgment for Medical Attention

Most patients with hypertension do not have typical symptoms, so it’s easily overlooked and not promptly treated. This suggests that high-risk groups should understand the general symptoms of hypertension and seek medical attention as soon as possible if they feel any discomfort. For general people

Diagnostic Process

When typical symptoms of hypertension or related suspicious symptoms occur, patients should seek medical attention promptly. The diagnostic process is as follows

Diagnostic Criteria

It is pointed out that without the use of antihypertensive drugs, there are 3 times when the clinic blood pressure values are higher than normal, that is, the clinic systolic blood pressure (commonly known as high pressure) ≥140mmHg and/or diastolic blood pressure (commonly known as low pressure) ≥90mmHg, and these 3 blood pressure measurements are not conducted on the same day, then it can be diagnosed as hypertension.

Department of Consultation

The routine treatment department for hypertension is cardiology or general internal medicine. For hypertension with complex symptoms, one can go to the hypertension clinic specially set up in a qualified hospital for treatment.

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Hypertension related examinations

Once the diagnosis of hypertension is considered, a comprehensive examination and evaluation should be conducted, including medical history investigation, physical examination, laboratory tests, genetic analysis, blood pressure measurement, and target organ damage assessment.
Medical history
Ask about family history, course of the disease, symptoms, past medical history, clues to secondary hypertension, lifestyle, and social and psychological factors. ### Physical examination

Hypertension prognosis

Disease Prognosis

Disease Prognosis

Hypertension is a controllable but incurable disease that requires lifelong treatment. Once you start medication, you can't stop or change medicines at will, otherwise, your blood pressure will rise again and become difficult to control. Long-term hypertension can cause serious complications such as heart disease, stroke, renal failure, fundus lesions, and even blindness, and threaten your life. Therefore, the treatment of hypertension requires that your blood pressure value meet the target and remain stable for a long time. If the treatment is effective, you can live and work like a normal person.

Complications

Complications

Among the many complications of hypertension, the incidence of hypertension with coronary heart disease is as high as 83%, and most hypertensive patients also have varying degrees of renal damage. The blood pressure control target is below 130/80 mmHg for these two types of patients. Hypertension is also an important cause of cerebral hemorrhage; at the same time, during the process of lowering blood pressure, it is also necessary to pay attention to the fact that too fast a blood pressure reduction may lead to insufficient cerebral perfusion, which may, in turn, induce cerebral infarction.

Hypertension treatment

The disease generally can be clinically diagnosed. If there are complex situations, it must be determined by the clinician based on the individual patient's situation. The fundamental goal of hypertension treatment is to reduce the overall risk of cardiovascular, cerebrovascular, renal, and vascular complications and death.

Treatment Goals

The acute phase of hypertension is different from other diseases. It specifically refers to the occurrence of hypertensive crisis (≥180/120 mmHg) under certain inducements. It is necessary to immediately lower blood pressure and control the blood pressure level to "slowly" drop. The treatment of hypertensive crisis is very complicated, and multiple systemic factors must be considered. Patients and their families should understand the treatment principles and cooperate with clinical treatment.

Treatment During Acute Phase

For most patients with hypertension, blood pressure should be gradually lowered to the target level within 4 weeks or 12 weeks, depending on the condition. Patients whose blood pressure still exceeds 140/90 mmHg and/or the target level after improving their lifestyle should be given drug treatment.

General Treatment

Due to the large individual differences, there is no absolute best, fastest, and most effective medication. In addition to commonly used OTC drugs, the most appropriate drugs should be selected under the guidance of a doctor in combination with personal conditions.

Treatment Drugs

### Lipid-lowering treatment If hypertension is accompanied by dyslipidemia, active antihypertensive treatment, and moderate lipid-lowering treatment should be received based on lifestyle changes. If there is no cardiovascular and cerebrovascular disease, lifestyle intervention should be strictly implemented for 6 months. If the blood lipid level is still not up to standard, drug lipid-lowering treatment should be considered. If there is already cardiovascular and cerebrovascular disease and hypertension is found, statin treatment should be started immediately, and cholesterol-lowering drugs should be combined if necessary.

Other Treatments

Daily precautions

Lifestyle intervention is a reasonable and effective treatment for any hypertensive patient at any time, and its purpose is to lower blood pressure, and control other risk factors and clinical conditions. All hypertensive patients should participate in self-management to varying degrees, take the initiative to prevent and treat hypertension, and have good compliance in taking antihypertensive drugs.

Daily Management

Lifestyle intervention is a reasonable and effective treatment for any hypertensive patient at any time, and its purpose is to lower blood pressure, and control other risk factors and clinical conditions.

Home Care

- In daily family life, patients with hypertension should pay attention to regular blood pressure measurement, a proper work and rest schedule, and a combination of work and rest.

Issues Needing Attention

Lifestyle intervention, especially nutrition and exercise intervention, plays an important role in the prevention and treatment of hypertension.

Exercise Guidance

### Exercise guidance Adhere to regular exercise, mainly aerobic exercise, and moderate-intensity aerobic exercise for at least 150 minutes per week. At the same time, ensure moderation and gradual progress.

Exercise Recommendations

Precautions for exercise for patients with hypertension - Strengthen blood pressure monitoring; - Specific groups of people must undergo additional exercise tests and carry out corresponding exercise training according to the test results under the guidance of a doctor;

Daily Monitoring

### Daily monitoring Home blood pressure monitoring requires the selection of appropriate blood pressure measuring instruments, and it’s recommended to use the upper arm home automatic electronic blood pressure monitors certified by international standards. Wrist blood pressure monitors, finger blood pressure monitors, and mercury column blood pressure monitors are not recommended for home blood pressure monitoring.

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