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For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
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 ] )
[18] [19] [20] High blood pressure affects 33% of the population globally. [9] About half of all people with high blood pressure do not know that they have it. [9] In 2019, high blood pressure was believed to have been a factor in 19% of all deaths (10.4 million globally). [9] Video summary
In particular, beta-blockers are no longer recommended as first-line treatment due to relative adverse risk of stroke and new-onset of type 2 diabetes when compared to other medications, [3] while certain specific beta-blockers such as atenolol appear to be less useful in overall treatment of hypertension than several other agents. [36]
The prevalence of labile hypertension in USA is estimated to have more than 40 million adults which can develop the risks of hemorrhagic stroke. [15] Labile hypertension is most common in Charlottesville, Virginia with up to 11% of the population. Average age who have labile hypertension is 64±13 years. [16]
Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with chronic hypertension develops signs of pre-eclampsia, typically defined as new onset of proteinuria ≥30 mg/dL (1+ in the dipstick) in at least 2 random urine specimens that were collected ≥4 h apart (but within a 7-day interval) or 0.3 g in a 24-h period. [19]
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Essential hypertension (also called primary hypertension, or idiopathic hypertension) is a form of hypertension without an identifiable physiologic cause. [1] [2] It is the most common type affecting 85% of those with high blood pressure. [3] [4] The remaining 15% is accounted for by various causes of secondary hypertension. [3]