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1 2005 Canadian Hypertension Education Program Recommendations : The bottom line version On behalf of the Evidence-Based Recommendations Task Force of the Canadian Hypertension Education Program Page 2 2 2005 marks the sixth consecutive year that the Canadian Hypertension Education Program has updated recommendations for the management of hypertension . The goal of this effort has been two-fold: 1) to offer those in clinical practice a consensus view of how to manage the more than 5 million Canadians with hypertension (based on a critical analysis of the most recent clinical trials data in the field) and 2) to utilize these updates as an opportunity to reiterate the key components of an optimal management program in hypertension . In some ways, the most notable aspect of the 2005 process is the appreciation that despite the advances made in the ...

1 2005 Canadian Hypertension Education Program Recommendations : The sound bite version On behalf of the Evidence-Based Recommendations Task Force of the Canadian Hypertension Education Program Page 2 2 2005 marks the sixth consecutive year that the Canadian Hypertension Education Program has updated recommendations for the management of hypertension . This year we have focused on the evidence supporting expedited assessment of both the hypertension -related risk of atherosclerotic disease as well as a more “global” atherosclerotic risk assessment. In addition, the 2005 recommendations support the increasingly held belief that, in the choice of antihypertensive drugs, consideration of the effectiveness of blood pressure control supersedes consideration of “pleiotropic” effects for the 5 major antihypertensive classes. The new key messages identified ...

AREA Male Female Male Female Male Female Male Female Male Female Male Female Male Female NUMBER RATE yrs. 5 - 14 15 - 49 50 - 64 65 yrs. NOTIFIABLE DISEASES: HYPERTENSION By Health Region, Province & City Philippines, 2002 By Age-Group and By Sex TOTAL BOTH SEXES 1 yr. yrs. TOTAL & above yrs. yrs. LESS THAN 1 - 4 PHILIPPINES 17 18 121 101 354 914 40,447 63,199 56,379 64,882 38,905 39,565 136,011 168,679 304,690 383.2 NAT. CAP. REGION 1 - 6 3 9 25 2,112 3,456 2,507 3,752 ...

AMERICAN SOCIETY OF HYPERTENSION (ASH) CHAPTER APPLICATION PROTOCOL 050930 1 1. Current members of the American Society of Hypertension , Inc. (ASH) have the option of establishing a steering committee to explore the option of establishing a new Regional Chapter of the American Society of Hypertension in a region where none exists. 2. The steering committee must obtain signed petitions from at least twenty current ASH Members who reside in the region of the proposed Chapter, supporting the establishment of the new ASH Chapter and agreeing to abide by Chapter licensing requirements. 3. In exploring this option, the steering committee will review the following documents available from the ASH Office regarding the role and function of ASH Chapters: • ASH Chapter Mission & Purpose Statement • ASH Chapter Bylaws template • ASH Chapter ...

2 3 P A T I E N T I N F O R M A T I O N G U I D E U N D E R S T A N D I N G H Y P E R T E N S I O N 1 What is hypertension ? Hypertension is another name for high blood pressure. It is a condition that occurs when the pressure inside of your large arteries is too high. Because it is a silent disorder, the only way to detect hypertension is to have your blood pressure measured. Hypertension is a very common problem that affects about 50 million people in the United States alone. It is more common as people grow older and is both more common and more serious in African Americans. Hypertension is not simply being tense or nervous. 2 What causes hypertension ? More than 9 of every 10 people who have hypertension do not have a cause for it that can be identified. We do know that you can inherit the tendency to hypertension ...

AMERICAN SOCIETY OF HYPERTENSION (ASH) CHAPTER LICENSING REQUIREMENTS 040506 1 In order to be licensed as a Regional Chapter of the American Society of Hypertension , Inc. (ASH), a Chapter must initially meet and maintain the following licensing requirements. Failure to meet these licensing requirements and performance criteria will constitute sufficient grounds for revocation of the Chapter license. 1. CHAPTER MISSION & PURPOSE STATEMENTS ASH Chapters must adhere to the ASH Chapter Mission & Purpose Statement: • The Chapters shall further the objectives of the American Society of Hypertension , Inc. (ASH) by organizing and conducting educational activities designed to promote and encourage the development, advancement, and exchange of scientific information in all aspects of research, diagnosis and treatment of hypertension , and ...

The Dietary Approaches to Stop Hypertension - Sodium Study (DASH-Sodium) Page 1 of 11 The Dietary Approaches to Stop Hypertension - Sodium Study (DASH-Sodium) Data Distribution Agreement The National Heart, Lung, and Blood Institute (NHLBI) and (Name of Recipient Organization) hereby enter into this Distribution Agreement as of the date specified on the final page hereof. PRELIMINARY STATEMENT The National Heart, Lung, and Blood Institute (NHLBI) has supported collection of data from participants in The Dietary Approaches to Stop Hypertension - Sodium Study (DASH-Sodium), hereafter referred to as “Study”. This well-characterized population provides a rare and valuable scientific resource. Promoting optimal use on a national scale of such a resource will require a large and concerted effort which may exceed the research capacity of currently available Study investigators. The NHLBI and the researchers ...

The Dietary Approaches to Stop Hypertension study (DASH) Page 1 of 11 Dietary Approaches to Stop Hypertension (DASH) Data Distribution Agreement The National Heart, Lung, and Blood Institute (NHLBI) and (Name of Recipient Organization) hereby enter into this Distribution Agreement as of the date specified on the final page hereof. PRELIMINARY STATEMENT The National Heart, Lung, and Blood Institute (NHLBI) has supported collection of data from participants in the Dietary Approaches to Stop Hypertension (DASH), hereafter referred to as “Study”. This well-characterized population provides a rare and valuable scientific resource. Promoting optimal use on a national scale of such a resource will require a large and concerted effort which may exceed the research capacity of currently available Study investigators. The NHLBI and the researchers it supports have a responsibility to the public in general, ...

The Patient Registry for Primary Pulmonary Hypertension (PPH Registry) Page 1 of 12 The Patient Registry for Primary Pulmonary Hypertension (PPH Registry) Data Distribution Agreement The National Heart, Lung, and Blood Institute (NHLBI) and (Name of Recipient Organization) hereby enter into this Distribution Agreement as of the date specified on the final page hereof. PRELIMINARY STATEMENT The National Heart, Lung, and Blood Institute (NHLBI) has supported collection of data from participants in The Patient Registry for Primary Pulmonary Hypertension (PPH Registry), hereafter referred to as “Study”. This well-characterized population provides a rare and valuable scientific resource. Promoting optimal use on a national scale of such a resource will require a large and concerted effort which may exceed the research capacity of currently available Study investigators. The NHLBI and the researchers ...

TABLE 1. CLASSIFICATION OF BLOOD PRESSURE LEVELS FOR PEOPLE 18 AND OLDER* Systolic BP Diastolic BP (mm Hg) (mm Hg) Normal <120 AND <80 Pre- Hypertension ** 120 to 139 OR 80 to 89 Stage 1 140 to 159 OR 90 to 99 Hypertension Stage 2 =160 OR =100 Hypertension * Based on the average of 2 or more correctly measured, seated readings taken on each of 2 or more office visits ** New category introduced in JNC-7 Report Adapted from: JNC-7, National Heart, Lung, and Blood Institute 5 October 2005 Vol. 24(7):39-50 U ncontrolled hypertension is a leading cause of preventable heart attack, stroke and death. The risk of death from cardiovascular disease and stroke begins to rise at levels as ...

Hypertension BMI Perc ent a ge 20 25 30 35 40 20 10 30 50 40 60 Relationship between BMI and crude percentage of women reporting medical problems, surgical procedures, symptoms, and health care utilization. Brown WJ et al. Int J Obes 1998;22:520-528. Page 2 BMI Perc ent a ge 20 25 30 35 40 0 10 5 15 Diabetes Brown WJ et al. Int J Obes 1998;22:520-528 . Relationship between BMI and crude percentage of women reporting medical problems, surgical procedures, symptoms, and health care utilization. Page 3 BMI Perc ent a ge 20 25 30 35 ...

Prepregnancy counseling: • Evaluate using JNC VI criteria • Discontinue use of ACE inhibitors and ARBs • Evaluate for target organ damage in women with longstanding hypertension • Discontinue use of tobacco and/or alcohol, even if not hypertensive • Discuss lifestyle changes, if applicable Chronic Hypertension in Pregnancy Page 2 Category SBP (mm Hg) DBP (mm Hg) Optimal < 120 and < 80 Normal < 130 and < 85 High-normal 130–139 or 85–89 Hypertension Stage 1 Stage 2 Stage 3 140–159 160–179 = 180 or or or 90–99 100–109 > 110 When SBP and DBP fall into different categories, use the higher category . JNC VI Classification of Blood Pressure for Adults ...

August 2005 Eligible Population Key Components Initial assessment Patient education and nonpharmacologic interventions Goals of Therapy Pharmacologic interventions Monitoring and adjustment of therapy [D] Approved by MQIC Medical Directors 08/05 www.mqic.org This guideline represents core management steps. It is based on the 2003 Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (www.nhlbi.nih.gov). Individual patient considerations and advances in medical science may supersede or modify these recommendations. Michigan Quality Improvement Consortium Guideline Medical Management of Adults with Hypertension The following guideline recommends diagnostic evaluation, education and pharmacologic treatment that support effective patient self-management. Recommendation ...

Blood Pressure Blood pressure is a measure of the force which is exerted by the blood on the walls of the arteries as the heart pumps it through the body. This pressure is expressed as two numbers, for example 120/80. The first number is the systolic pressure, the pressure inside the arteries when the heart is contracting. The second number is the diastolic pressure, the pressure level during the time the heart muscle is relaxing. Normal Readings Health care providers consider the average range for blood pressure to be from 90-140 systolic, and from 60- 90 diastolic. An average optimum level is 120/80 or less. Blood pressure is generally viewed as high if it is consis- tently above 140 systolic and 90 diastolic. If you have several readings above 140/90 you should be evaluated by a medical provider. NOTE A single elevated blood pressure reading DOES NOT mean you ...

1 A Report on World Hypertension Day in Isfahan-Iran May 14 th 2005 Isfahan Province is located in central Iran and has a population of 2 million. A recent report as part of IHHP (Isfahan Healthy Heart Project), a national plan for chronic disease prevention and control ( www.ihhp.mui.ac.ir ) showed that the prevalence of hypertension in Isfahan is 18%, but only 12% of hypertensive patients were well controlled. Studies conducted by Isfahan Cardiovascular Research Center (ICRC) have revealed that public awareness of hypertension and its treatment has increased from 28% to 51% during the last decade. To improve the public knowledge on the World Hypertension Day on May 14 th 2005, the Scientific Committee of High Blood Pressure of the Iranian Heart Foundation ( www.hbi.ir/hosting/ihf/ihf.htm ), and the Hypertension Unit of Isfahan Cardiovascular Research ...

DRUGS USED TO TREAT HYPERTENSION There are many drugs that can be used to treat hypertension . Most of these drugs could also be used to treat other cardiovascular diseases as such as CHF, angina, and dysrhythmias because of where they work in the vasculature or in the heart. In this section, the drugs will be examined for their ability to lower blood pressure—but keep in mind the other potential uses of these medications. Hypertension is a highly prevalent medical problem in the U.S. It is aggravated by things such as obesity, stress, poor diet, and lack of exercise. Most people suffer from primary hypertension —HTN not due to any one identifiable cause. A small percentage of patients may have secondary HTN—caused by an adrenal tumor, for example. In both cases, blood pressure is elevated above the “recommended” level of 120/80—how much the elevation is will direct whether to treat with drugs, and ...

August Feature Articles The British Hypertension Society The British Hypertension Society (BHS) is a society much like our own with over 230 members formed with the aim to promote the advancement of knowledge and dissemination of information concerning the pathophysiology, epidemiology, detection, investigation and treatment of arterial hypertension and related vascular diseases with in the United Kingdom. They provide a medical and scientific research forum to enable sharing of cutting edge research in order to understand the origin of high blood pressure and improve its treatment. The BHS formed in the early 1980’s has a strong track record of producing internationally renowned guidelines for the management of hypertension which are widely adopted in primary care in the UK and elsewhere. As part of our increasing engagement in improving blood pressure measurement they are now undertaking ...

Pioglitazone Prevents Hypertension and Reduces Oxidative Stress in Diet-Induced Obesity Anca D. Dobrian, Suzanne D. Schriver, Ali A. Khraibi, Russell L. Prewitt Abstract —The objective of this study was to determine the effect of pioglitazone on blood pressure (BP) and oxidative balance in obese, hypertensive, Sprague-Dawley rats and to identify some of the molecular mechanisms involved. After 12 weeks of a moderately high-fat diet, rats diverged into obesity-prone (OP) and obesity-resistant (OR) groups (n 6 per group). At the end of the diet, peroxisome proliferator activated receptor- (PPAR ) mRNA expression and activity in the renal cortex and medulla of OP rats were significantly lower compared with that in OR rats. Pioglitazone treatment increased PPAR expression and activity in OP rats, suggesting a possible direct ligand-related effect of pioglitazone. As opposed to the untreated OP group, which showed moderate ...

This document was prepared by the staff of the UWSP University Health Service. This information should not be used in lieu of medical care. Last updated: November 2004 Hypertension .doc High Blood Pressure ( Hypertension ) What is Hypertension ? Hypertension , often called high blood pressure, occurs when blood moving through your arteries places too much force against the artery walls. A person is told they have high blood pressure if their blood pressure readings are repeatedly above normal for a long time. What do the Numbers Mean? The top (first) number is the systolic pressure . This is the pressure in the arteries when the heart contracts. The bottom (second) number is the diastolic pressure. This is the pressure in the arteries when the heart relaxes and refills between each heartbeat. Table 1: Classification of Blood Pressure ...

Stang J, Story M (eds) Guidelines for Adolescent Nutrition Services (2005) 125 http://www.epi.umn.edu/let/pubs/adol_book.shtm Chapter 11 HYPERTENSION Irene Alton Essential, or primary hypertension is a persistent elevation of blood pressure which is not caused by underlying cardiac, endocrine, or renal disease. 1 Approximately 70% of blood pressure elevations in youth represent early onset of essential hypertension . 1,2 • Adolescents 17 years of age or younger are considered to be hypertensive if their average systolic and/or diastolic blood pressure measurements on three visits are at or above the 95th percentile for age, gender and height (Tables 1, 2, 3). 3 • Adult standards are used to evaluate blood pressure elevations in adolescents who are 18 years or older (Table 4). 4 An average of at least ...

Physical inactivity and hypertension Cardiovascular diseases (CVDs) account for a large proportion of mortality in adults older than 45 years. Numerous risk factors for CVD including hypertension , diabetes, obesity and hypercholes- terolemia are suspected to be influenced by fitness, and these fac- tors may mediate the association between low fitness and mortal- ity (1-2). Physical inactivity is strongly positively associated with hypertension . Although the evidence from observational studies is strong for an inverse relationship between physical activity level and blood pressure (BP), these studies are limited by the inability to ensure that all other factors that affect BP are the same between active and non-active groups. Young adults with low fit- ness were 3-to-6 fold more likely to develop diabetes, hyperten- sion and the metabolic syndrome than those with high fitness (3). Benefits of physical ...

Introduction Arrhythmia-both atrial and ventricular-is a common comorbidity with hypertension (HT). Underlying mechanisms are many and various, including left ventricular hypertrophy (LVH), myocardial ischemia, impaired left ventricular function and left atrial enlarge- ment. Any form of arrhythmia may be associated with LVH but ventricular arrhythmia is more common as well as being more dangerous. Atrial arrhythmia Prevalence After supraventricular extrasystole, atrial fibrillation (AF) is the next most common form of arrhythmia associated with HT. The relative risk of developing AF in HT is modest compared with other conditions, such as heart failure and valve disease. Nevertheless, HT is the most prevalent, independent, and potentially modifiable risk for AF (1). AF is most common after the age of 65 and in men (2). Mechanisms Changes in atrial electrical properties occur early ...

Why is it important to know about hypertension ? Hypertension means ‘high blood pressure’. It is a major cause of heart disease, stroke and kidney disease. About 50% of people who have a heart attack and 66% who have a stroke have hypertension . About one in four adults has hypertension , but only about one-third of those are aware that their blood pressure is high. In fact, hypertension usually doesn’t have any warning signs and has been called "the silent killer." But fortunately, treatment is available and effective. Who is likely to develop hypertension ? What are the risk factors? • Age (over 35) • Excessive weight • Physical inactivity • Family history of hypertension • Diabetes, gout and kidney diseases • Excessive salt intake • Excessive alcohol intake • Pregnancy • Race - African-Americans are at higher ...

Pulmonary hypertension Laurent P. Nicod Pulmonary division, University Hospital, Geneva, Switzerland Pulmonary arterial hypertension (PAH) has often been misdiagnosed in the past, due to the poor specificity of symptoms early in the disease until the appearance of right heart failure. Al- though primary pulmonary hypertension (PPH) remains a rare disease, in recent times PAH related to other diseases has been better recognised. These forms are related to systemic connective tissue dis- eases, thromboembolic disease, congenital heart disease, portal hypertension or HIV infection, or are secondary to the use of drugs as anorexigens. They all result in an indistinguishable histological picture [1, 2]. Improved understanding of the pathogenesis of PPH has produced new treatments, not only for PPH but for PAH related to other diseases. Ge- netic predisposition has been found ...

Hypertension Research in Perth This month’s article focuses on Hypertension Research in our most Western Capitol, Perth. We have contributions from three groups at the Royal Perth Hospital. Founded in 1829, the 855 bed hospital admits over 67,000 patients per year performing nearly 16,000 operations annually. It is not surprising then that RPH is a major teaching and research Hospital in Western Australia. The Hospital has a close association with the School of Medicine at the University of Western Australia, and with other state universities involved in the training of nursing and other health professionals. Its research output is outstanding with over 150 articles per year. There is also a great contribution from Jackie Philips now at the School of Veterinary and Biomedical Sciences at Murdoch University. Neurocardiology Research Group : Royal Perth Hospital Professor Leonard Arnolda ...

CYCLOSPORIN-INDUCED HYPERTENSION Renata Cífková, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; and Hermann Haller, Medizinische Hochschule Hannover, Hannover, Germany Introduction: Hypertension has emerged as a serious adverse effect of immunosuppression with cyclosporin, which has become the mainstay of immunosuppression in organ transplantation. Improved survival rates with cyclosporin com- pared to previous regimens based on corticosteroids and aza- thioprine were established and have led to an expansion of solid organ transplantation. Cyclosporin has also been used at lower dosages for the treatment of autoimmune disease. Cyclosporin is a macrolide antibiotic structurally different from the newer immunosuppressive agent tacrolimus, although both share final pathways that inhibit cytokine release from lymphocytes. Both cyclosporin and tacrolimus induce wide- ...

ESH Definition and Prevalence Hypertension is still a major health problem affect- ing approximately 30% of the population by the age of 60 years. 10% of the hypertensive patients appear resistant to therapy (1,2). Resistant hyper- tension is defined as failure of concomitant use of three or more different antihypertensive agents to lower blood pressure to less than 140/90 mmHg (3) in all age groups. Older studies estimated the preva- lence of refractory hypertension in tertiary care cen- ters to be between 5 and 18 % (4-9). In a large cohort study Alderman et al. found that only 2.9% were resistant to antihypertensive therapy (10). Recent clinical trials suggest that resistant hyper- tension is increasingly common. ALLHAT (Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack) Study results indicate a high- er prevalance. Among 14722 patients above 55 years, ...

and parenchymal diseases. More specifically, umbilical artery catheter-associated thromboembolism affecting either the aorta and/or the renal arteries probably accounts for the major- ity of cases of hypertension seen in the typical neonatal inten- sive care unit (4). In very young children (<6 years), hypertension is most often the result of such renal parenchymal disease as glomerulonephritis, renal scarring, polycystic kidney diseases, and renal dysplasia. Renal artery stenosis and cardiovascular disorders like coarctation of the aorta, less frequent causes of hypertension in this age group, are usually detected within the first decade of life. Late in the first decade and throughout the second, essen- tial hypertension becomes the most common cause of sus- tained hypertension , particularly in those children with mild asymptomatic disease. In this age group, a predominance of isolated ...