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Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
The practice of intracardiac injection originated in the 1800s. It was commonly performed during the 1960s, as it was considered the fastest way to get medication to the heart. The practice began declining during the 1970s as more reliable delivery methods (i.e., intravenous , endotracheal , and intraosseous ) came into use.
Guidelines for treating resistant hypertension have been published in the UK [45] and US. [46] It has been proposed that a proportion of resistant hypertension may be the result of chronic high activity of the autonomic nervous system, known as "neurogenic hypertension". [47] Low adherence to treatment is an important cause of resistant ...
Which type of medication to use initially for hypertension has been the subject of several large studies and resulting national guidelines. The fundamental goal of treatment should be the prevention of the important endpoints of hypertension, such as heart attack, stroke and heart failure.
The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. [ 35 ] Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. [ 36 ]
Consequently, in many older people, systolic blood pressure often exceeds the normal adult range, [33] if the diastolic pressure is in the normal range this is termed isolated systolic hypertension. The rise in pulse pressure with age is attributed to increased stiffness of the arteries . [ 34 ]
Careful monitoring for signs of end-organ damage or progression to hypertension is an important part of the follow-up of patients with prehypertension. Any change in blood pressure classification should be confirmed on at least one subsequent visit. The major indication for pharmacologic antihypertensive therapy is progression to hypertension.
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