Hypertension

Arnold B Alper, University of Alabama, Birmingham, Alabama, USA
David A Calhoun, University of Alabama, Birmingham, Alabama, USA
Suzanne Oparil, University of Alabama, Birmingham, Alabama, USA

Published online: April 2001

DOI: 10.1038/npg.els.0002303

Hypertension is defined as a sustained increase in blood pressure. Historically, the level of blood pressure designating hypertension has been a systolic blood pressure of 140 mmHg or more and/or a diastolic blood pressure of 90 mmHg or more. However, the risk imparted with increasing blood pressure is continuous, such that the level of blood pressure must be considered within the context of the overall cardiovascular risk profile.

Keywords: blood pressure; cardiovascular disease; antihypertensive therapy; pulse pressure

Figure 1. Frequency distribution of diastolic blood pressure of 158 906 persons aged 30–69 years in the Hypertension Detection and Follow-Up Program. From Hypertension Detection and Follow-Up Program Cooperative Group (1977) The Hypertension Detection and Follow-Up Program: a progress report. Circulation Research 40 (supplement 1): 106–109.
Figure 2. Prevalence of blood pressure by age and race/ethnicity for men and women in the United States aged 18 years or older. From Burt VL, Whelton P, Rocella EJ et al. (1995) Prevalence of hypertension in the US adult population: results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension 25: 305–313. Estimate based on a sample size not meeting minimum requirements of the National Health and Nutrition Survey III design or relative SEM greater than 30%.
Figure 3. Effects of talking on blood pressure measurement. Systolic and diastolic blood pressure measurements were taken during office visits, before and after periods of silence, talking and quiet reading. From Le Pailleur C, Helft G, Landais P et al. (1998) The effects of talking, reading, and silence on the ‘white coat’ phenomenon in hypertensive patients. American Journal of Hypertension 11: 203–207. Each bar represents the mean ± 2 SEM.
close
 References
    Appel LJ, Moore TJ, Oberzanek E et al. for the DASH Collaborative Research Group (1997) A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine 336: 1117–1124.
    Burt VL, Whelton P, Roccella EJ et al. (1995) Prevalence of hypertension in the US adult population: results from the third National Health and Nutrition Survey, 1988–1991. Hypertension 25: 305–313.
    Klag MJ, Whelton PK, Randal BL et al. (1997) End-stage renal disease in African-American and white men: 16-year MRFIT findings. Journal of the American Medical Association 277: 1293–1298.
    Midgley JP, Matthew AG, Greenwood CMT and Logan AG (1996) Effect of reduced dietary sodium on blood pressure, a meta-analysis of randomized controlled trials. Journal of the American Medical Association 275: 1590–1597.
    National Heart, Lung and Blood Institute Working Group (1982) Management of patient compliance in the treatment of hypertension. Hypertension 4: 415–423.
    Paffenbarger RS Jr, Hyde RT, Wing AL et al. (1993) The association of changes in physical-activity level and other lifestyle characteristics and mortality among men. New England Journal of Medicine 328: 538–545.
    Pickering JG, Kaplan NM, Krakoff L et al. (1996) American Society of Hypertension Expert Panel: conclusions and recommendations in the clinical use of home (self) and ambulatory blood pressure monitoring. American Journal of Hypertension 9: 1–11.
    Sica DA (1994) Fixed-dose combination antihypertensive drugs. Do they have a role in rational therapy? Drugs 48: 16–24.
    Stamler J, Caggiula AW and Grandits GA (1997) Relation of body mass and alcohol, nutrient, fiber, and caffeine intakes to blood pressure in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. American Journal of Clinical Nutrition 65 (supplement): 338S–365S.
    Yakovlevitch M and Black HR (1991) Resistant hypertension in a tertiary care clinic. Archives of Internal Medicine 151: 1786–1792.
 Further Reading
    Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (1997) The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Archives of Internal Medicine 157: 2413–2446.
    Kannel WB, Gordon T and Schwartz MT (1971) Systolic versus diastolic blood pressure and the risk of coronary heart disease: The Framingham Study. American Journal of Cardiology 27: 335–346.
    Miller NH, Hill M, Kottke T and Ockene IS (1997) The multilevel compliance challenge: recommendations for a call to action. A statement for healthcare professionals. American Heart Association special report. Circulation 95: 1085–1090.
    Mulrow CD, Cornell JA, Herrera CR et al. (1994) Hypertension in the elderly. Implications and generalizability of randomized trials. Journal of the American Medical Association 272: 1932–1938.
    Perloff D, Grim C, Flack J et al. (1993) Human blood pressure determination by sphygmomanometry. Circulation 88: 2460–2470.
    book Staessen JA and Wang JG (1999) "Characteristics of published, ongoing, and planned outcome trials in hypertension". In: Oparil S and Weber MA (eds) Hypertension: Companion to Brenner and Rector's the Kidney, pp. 341–359. Philadelphia, PA: WB Saunders.
    book World Health Organization (1997) The World Health Report 1997: Conquering Suffering, Enriching Humanity. Geneva: WHO.
    WHO-ISH (1999) World Health Organization–International Society of Hypertension guidelines for the management of hypertension, 1997. Journal of Hypertension 17: 151–183.

Related Sub-Topics:

Health Care
Contact Editor close
Submit a note to the editor about this article by filling in the form below.

* Required Field

Article Title: Hypertension
 
How to Cite close
Alper, Arnold B, Calhoun, David A, and Oparil, Suzanne(Apr 2001) Hypertension. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0002303]