Abstract

Hypertension is defined as either an elevation of systolic blood pressure (SBP) to ≥ 140 mmHg and/or elevation of diastolic blood pressure (DBP) to ≥ 90 mmHg for adults. Hypertension is a frequent, age-related disorder and a major risk factor for stroke, coronary heart disease, heart failure and renal failure. The relation between BP and cardiovascular disease (CVD) mortality and morbidity is strong, direct and continuous over a wide range such that BP values must be viewed as a continuum in which a high BP means an increased cardiovascular risk and worse prognosis. Thus, the paradigm has shifted from hypertension to BP-related diseases. The magnitude of the burden of hypertension and high BP in both developed and developing countries contributes to prediction of worldwide epidemic of CVD. Effective strategy emphasizes focusing on SBP, identifying high-risk patients and targeting reductions in multiple risk factors, including end-organ damages. Recent studies have focused on six modifiable risk factors, namely cigarette smoking, lipids abnormalities, diabetes, BP levels, obesity, and stress. Three protective factors have also been individualized, namely the Mediterranean regimen, regular physical activity and regular, moderate alcohol consumption. Besides health promoting lifestyle modifications, the major classes of antihypertensive agents, namely diuretics, β-blockers, calcium antagonists, angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, are suitable for the initiation and maintenance of therapy, and there is a frequent need to use at least two drugs in combination in order to achieve optimal BP. It is important to point out the fact that most clinical trials are of short duration and their significance must be confirmed on longterm outcomes.

Keywords: Hypertension, blood pressure, diabetes, cardiovascular risk, cardiovascular diseases