Blood pressure

Have your blood pressure
checked three to four times a
Current guidelines state that
year; it should be less than
normal blood pressure is less than
World Wide estimates of individuals
130/80mm Hg.
with hypertension are 1 billion
Pre-hypertension is systolic blood
people currently.
(Source: Joint National Committee
pressure of 120-139mm Hg or diastolic
On Prevention, Detection, Evaluation blood pressure of 80-89mm Hg.
In 2000, 972 million adults were
Stage 1 hypertension is systolic
estimated to have hypertension (high
And Treatment Of High Blood
blood pressure of 140-159 mm Hg or
blood pressure) worldwide. By 2025,
diastolic blood pressure of 90-99 mm
that number is estimated to rise to
1.56 billion. (The Lancet; 365: 9455
Stage 2 hypertension is systolic
January 15, 2005:217-223)
blood pressure of 160mm Hg or greater
or diastolic blood pressure of 100mm
73 million individuals in the United
My blood pressure is _________.
Hg or greater.
States had hypertension in 2005.
Regular screening for
See if your doctor can prescribe
hypertension should be done at least
every 2 years and more frequently in
The risk of cardiovascular disease,
an ARB Therapy (Angiotensin
minority population and the elderly.
beginning at 115/75 mm Hg doubles
Receptor Blocker) (Example:
with each increment of 20/10 mm Hg.
Valsartan, Irbesartan, Losartan),
(Source: Joint National Committee On
or ACE Inhibitor Therapy
Prevention, Detection, Evaluation And
(Source: Joint National Committee
Treatment Of High Blood Pressure.
On Prevention, Detection, Evaluation
(Angiotensin Converting Enzyme
And Treatment Of High Blood
Inhibitor) (Example: Ramipril,
Lisinopril, Enalapril) for blood
pressure control and for
The JNC VII/American Diabetes
Association/American Heart
protective effect for your kidneys,
Association/recommendation is
Every 10mm lower usual systolic
heart, and brain.
maintaining blood pressure of less
blood pressure or a 5mm lower usual
than 130/80 mm Hg.
diastolic blood pressure would
Combination therapy using ARB
predict a 50-60% lower risk of stroke
death and approximately 40-50%

Therapy (Example: Valsartan,
lower risk of death due to coronary
Irbesartan, Losartan) or ACE
artery disease or other vascular
Inhibitor Therapy (Example:
Ramipril, Lisinopril, Vasotec) With
(AHA Scientific Statement
Circulation, 2007; 115:2761-2788

a Calcium Channel Blocker
Clive Rosendorff M.D.
(Amlodipine) may provide faster
achievement of blood pressure
goal and better protective effect
for your heart and brain.
Controlling blood pressure leads
to 16-25% risk reduction for MI,

stroke, and cardiovascular
You may need additional therapy
mortality (ASCOT, LIFE,
with beta blockers, calcium channel

blockers, and direct renin inhibitor to
Controlling blood pressure
achieve blood pressure goal.
reduces stroke risk by 22-50%
My blood pressure medications are
Controlling blood pressure with
Valsartan in the VALUE Trial, led
to 19% fewer hospitalizations for
heart failure, compared to the
Amlodipine group.

However failure to control blood
pressure with Valsartan to the
same level as Amlodipine in the
first 6 months, led to increased
risk of stroke, myocardial
infarction, and death.

Therefore it is important to achieve
blood pressure goal sooner than
(Stevo Julius et al. The Lancet; 19.
June, 2004;363;9426;2022-2031

Controlling blood pressure with a
combination of calcium channel
blocker (Amlodipine) and ACE
inhibitor (Perindopril) showed a 14-
26% risk reduction for myocardial
infarction, angina, heart failure,
stroke, peripheral arterial disease,
new onset of renal insufficiency, and
cardiovascular events and mortality
compared to the regimen using beta-
blocker (Atenolol) and thiazide
(ASCOT-BPLA Study: Björn Dahlöf et
al. The Lancet; 366;9489;895-906


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