Hypertension is a major risk factor for stroke (both ischaemic and haemorrhagic), myocardial infarction, heart failure, chronic kidney disease, peripheral vascular disease, cognitive decline and premature death worldwide.(Kearney 2005) If the condition is untreated, there is a progressive rise in blood pressure, which often results in a treatment resistant state due to vascular and renal damage (itself caused by the untreated hypertension).(NICE 2011)

 

At least 25% of the adult population in the UK have hypertension (i.e. a blood pressure of 140/90mmHg or more), and over half of those over the age of 60 years are affected.(NICE 2011) The prevalence is strongly influenced by age and lifestyle factors. Raised systolic pressure is the more dominant feature of hypertension in older patients, while raised diastolic pressure is more common in younger patients (i.e. those under 50 years of age).(NICE 2011) Because routine periodic screening for high blood pressure is commonplace in the UK, the diagnosis, treatment and follow-up of patients with hypertension is one of the most common interventions in primary care; it actually accounts for around 12% of consultations in general practice.(NICE 2011)

 

Lifestyle interventions to lower blood pressure include reducing salt, caffeine and alcohol intake, taking regular exercise, stopping smoking and relaxation therapies (e.g. meditation, yoga). Approximately £1 billion was spent on drugs for hypertensions in the UK in 2006.(NICE 2011) Drugs used to treat hypertension include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium-channel blockers, diuretics and beta-blockers.

 

References

Kearney PM et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217–23.

National Clinical Guideline Centre. Hypertension. The clinical management of primary hypertensions in adults. Clinical Guideline 12. August 2011. Available: http://www.nice.org.uk/nicemedia/live/13561/56007/56007.pdf