Blood pressure and control of cardiovascular risk.
Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving away from a dichotomous approach to risk classification, and away from notions of hypertension and normotension towards an appreciation that blood pressure-related risk is continuous. In parallel, there has been a paradigm shift from a single risk factor approach to comprehensive cardiovascular disease risk prevention. Accordingly, prevention of cardiovascular disease requires a focus on lowering of blood pressure and modification of associated risk factors rather than simply treatment of hypertension. This emphasis is reflected in the World Health Organization (WHO)-International Society of Hypertension (ISH) 2003 statement on management of hypertension.
Whitworth
Judith A
JA
John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia. director@jcsmr.anu.edu.au
D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D005060:Europe; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012955:Societies, Medical; D014481:United States; D014944:World Health Organization
D000959:Antihypertensive Agents