7. Epidemiology and prevention of hypertension

From greek.doctor
  • 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
    • 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
  • Treatment
    • < 5% risk and no organ damage
      • Lifestyle changes for 6 months
        • If successful -> annual control
        • If unsuccessful -> therapy may be necessary
    • < 5% risk with organ damage
      • Lifestyle changes + therapy