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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 ] )
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]
[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
This is because they have been associated with increased risk of new-onset diabetes and as such are recommended for use in patients over 65, for whom the risk of new-onset diabetes is outweighed by the benefits of controlling systolic blood pressure. [8] Another theory is that they are off-patent and thus rarely promoted by the drug industry. [9]
In panic disorder, elevation of blood pressure is generally mild and is normally triggered by fear or panic. [4] There is a small percentage, approximately 2% who raises suspicion for have pheochromocytoma, a tumour in the adrenal glands. This involves the sympathetic nervous system and treatment for paroxysmal hypertension is available. [5]
(1 unit corresponds to 1/8 liter of wine or 1/4 liter of beer). [7] In addition to lifestyle changes, medication can also be used to reduce systolic hypertension to safe levels. [8] [9] Common medications used to treat systolic hypertension include a thiazide-type diuretic (TTD) or calcium channel blockers (CCB), or a combination of the two. [10]
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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]