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The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit and others finding unclear benefit. The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy. Up to three medications taken concurrently can control blood pressure in 90% of people. If lifestyle changes are not sufficient, then blood pressure medications are used. Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement. For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg) systolic and 60–80 mmHg diastolic. īlood pressure is classified by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. High blood pressure is classified as primary (essential) hypertension or secondary hypertension. Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. High blood pressure usually does not cause symptoms. Hypertension ( HTN or HT), also known as high blood pressure ( HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. Lack of sleep, Excess salt, excess body weight, smoking, alcohol Air Pollution
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It is also appropriate to initiate treatment with lower doses of antihypertensive agents and to bring the pressure down more slowly, monitoring for orthostatic hypotension, impaired cognition, and electrolyte abnormalities.Arterial hypertension, high blood pressureĪutomated arm blood pressure meter showing arterial hypertension (shown by a systolic blood pressure 158 mmHg, diastolic blood pressure 99 mmHg and heart rate of 80 beats per minute)Ĭoronary artery disease, stroke, heart failure, peripheral arterial disease, vision loss, chronic kidney disease, dementia It is both appropriate and necessary to treat elderly hypertensive patients aggressively to the same target BPs identified for younger patients. However, controversy continues as to the choice of antihypertensive agents and combinations of agents.
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A number of clinical trials have clearly demonstrated that treatment of hypertension significantly reduces the cardiovascular event rate in older patients. Isolated systolic hypertension, defined as an SBP ≥140 mm Hg with a DBP less than 90 mm Hg, affects the majority of individuals ages 60 years and older. Elevated SBP and increased PP unquestionably increase the risk of both fatal and nonfatal cardiovascular events, including stroke, myocardial infarction, and heart failure. Two phenotypes exist in the older patient: elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP) with a normal pulse pressure (PP), and elevated SBP with an increased PP. High blood pressure (BP), once believed to represent a normal and progressive component of the aging process, is now recognized as a manifestation of structural and physiologic abnormalities of arterial function.