EPIDEMIOLOGY

CLUB DE REVISTA MARZO 26 2014GUIAS DE HYPERTENSION JNC 8

EPIDEMIOLOGY Worldwide prevalence is around 20% , and approximately 7.1 million deaths per year may be attributable to hypertension

The WHO reports that suboptimal BP (>115 mmHg SBP) is responsible for 62 percent of cerebrovascular disease and 49 percent of ischemic heart disease (IHD)

Suboptimal BP is top attributable risk factor for death throughout the world

Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988- 2000. JAMA 2003;290:199-206

Global Leading Risks for DeathSystolic blood pressure > 115 mmHgGlobal Burden of Disease Study 2010 , Lancet 2012; 380: 222460

Increased blood pressure is the leading risk for death and disability globally according to the Global Burden of Disease Study published in 2012 3

Impact of a 5 mmHg ReductionOverall ReductionStroke14%Coronary Heart Disease9%All Cause Mortality7%

Hypertension 2003;289:2560-2572.

The Natural History of UntreatedHypertension

Untreated hypertension is a self-accelerating condition Evolving arteriolar hypertrophy, and endothelial dysfunction facilitate the later increase of BP transition to higher stage

A summary of nearly all placebo- controlled early outcomes trials in hypertension indicated that 1493 of 13,342 (11.2%) subjects in the placebo groups progressed in stages of hypertension, Compared with only 95 of 13,389 ( 0.7%) in the drug-treated groups

Hansen TW, Staessen JA, Zhang H, et al. Cardiovascular outcome in relation to progression to hypertension in the Copenhagen MONICA cohort. Am J Hypertens. 2007;20: 483-491

Writing Group of the American Society of Hypertension (WG-ASH)

Writing Group of the American Society of Hypertension (WG-ASH)

Date of download: 12/21/2013Copyright 2012 American Medical Association. All rights reserved.From: 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)JAMA. 2013;():. doi:10.1001/jama.2013.284427

Comparison of Current Recommendations With JNC 7 GuidelinesFigure Legend:

8

Stratification of total CV risk in HTN patients ESC 2013

General population aged 60 years or older

Recommendation 1

SBP 150 mmHg OrDBP 90mmHgGoal of Treatment : SBP