7. Epidemiology and prevention of hypertension
- Hypertension
- Systolic > 140 mmHg
- Diastolic > 90 mmHg
- Most are primary
- Symptom-free
- Epidemiology
- Most prevalent in eastern Europe, southern Africa
- More prevalent in blacks
- More prevalent in lower socioeconomic classes
- Prevalence increases with age
- < 50: more frequent among men
- > 65: more frequent among women
- Risk factors
- Familial factors
- Nutritional
- Salt intake > 5g/day
- Hungary has extremely high salt intake (17 g per day)
- Soft water
- High tyramine content – sympathetic activation
- Alcohol
- Salt intake > 5g/day
- Obesity
- 12% risk increase for each unit BMI
- Body weight
- 10 kg increase – 2 systolic, 1 diastolic
- Physical inactivity
- Modern lifestyle
- Lots of stress
- Diabetes
- Prevention
- BMI < 25
- 5 – 20 mmHg reduction per 10 kg
- DASH diet
- Lots of vegetables, fruits
- Grains
- Lean meat, low fat dairy
- Oils, beans, nuts
- Little sweets
- reduces 8 – 14 mmHg
- Salt < 5g/day
- reduces 2 – 8 mmHg
- Increase Ca, K, Mg
- Moderate alcohol consumption
- reduces 2 – 4 mmHg
- Stop smoking
- Physical activity
- reduces 4 – 9 mmHg
- BMI < 25
- Treatment
- < 5% risk and no organ damage
- Lifestyle changes for 6 months
- If successful -> annual control
- If unsuccessful -> therapy may be necessary
- Lifestyle changes for 6 months
- < 5% risk with organ damage
- Lifestyle changes + therapy
- < 5% risk and no organ damage