Abstract
Hypertension is the most common modifiable risk factor for death and disability including stroke, accelerated coronary and systemic atherosclerosis, heart failure, chronic kidney disease, lowering the BP with antihypertensive drugs, and reducing the target organ damage and prevalence of the occurrence of cardiovascular disease. According to the 2017 American college of cardiology (ACC)/American heart association (AHA) hypertension guidelines hypertension is defined as systolic BP is ≥130 mmHg or diastolic BP is ≥80 mmHg. BP should be lower than 130/80 mmHg in patient with CHD, CHF, after renal transplantation, diabetes mellitus and stroke. Recommended lifestyle modification included restriction of dietary sodium intake, weight loss if patient is overweight, regular exercise, moderate alcohol intake and increase consumption of potassium rich foods. The initial antihypertensive agent should be generally selected from one of the following four classes—thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers, shown to reduce cardiovascular events. There are two interventional approaches—Renal Denervation and Baroreflex activation therapy, which are used in clinical practice for treatment of several treatment resistant hypertensions. Other interventional approaches are carotid body ablation and AVF placement but none of them prevent cardiovascular disease outcome or death in hypertensive patient.
Highlights
Blood pressure. SBP (BP) should be lower than 130/80 mmHg in patient with Coronary heart disease. CHF (CHD), CHF, after renal transplantation, diabetes mellitus and stroke
In recent years hypertension has been defined as a BP of 140/90 mmHg or more, the 2017 American College of Cardiology-American Heart Association (ACC-American heart association (AHA)) Hypertension Guideline adopted a lower threshold, in which hypertension is defined as a systolic BP of 130 mmHg or more or a diastolic BP of 80 mmHg or more [1]
There are two interventional approaches like Renal Denervation and Baroreflex activation therapy, which are most commonly used in clinical practice, and other interventional approaches like AVF, Renal artery Stenting are not used
Summary
Hypertension is the elevation of systolic BP, diastolic BP, or both above normal levels, is common in developed and developing countries and increases in pre-. A total of 69 drugs in 15 different classes, many of which are available in single pill combinations, have been approved for the treatment of hypertension in the United States Despite this treatment options, an estimated 10% to 15% of the general RH, is defined as uncontrolled BP on ≥3 antihypertensive drugs of different classes, in which one of them is diuretic, at optimal doses or requiring ≥4 drug to control blood pressure [7] [8] and causes of RH are primarily hyperaldosteronism, Renovascular disease, Cushing syndrome and Pheochromocytoma. SPRINT (systolic BP intervention trial) randomized 9361 adults to a systolic BP goal of
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