Hypertension/ high blood pressure facts , trends and latest research

Hypertension/ High Blood Pressure

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure the harder the heart has to pump.
 extracted from http://www.who.int/topics/hypertension/en/

Situation and trends

Raised blood pressure is one of the leading risk factors for global mortality. Raised blood pressure is a major risk factor for coronary heart disease and ischemic as well as hemorrhagic stroke. Blood pressure levels have been shown to be positively and continuously related to the risk for stroke and coronary heart disease.

 In addition to coronary heart diseases and stroke, complications of raised blood pressure include heart failure, peripheral vascular disease, renal impairment, retinal hemorrhage and visual impairment.

Globally, the overall prevalence of raised blood pressure in adults aged 18 and over was around 22% in 2014. Across the WHO regions, the prevalence of raised blood pressure was highest in Africa, where it was 30% for both sexes combined as well as for men and women separately.
The lowest prevalence of raised blood pressure was in the WHO Region of the Americas at 18% for both sexes. Men in this region had higher prevalence than women (21% for men and 16% for women). In all WHO regions, men have slightly higher prevalence of raised blood pressure than women. Looking at the data by World Bank income group, the prevalence of raised blood pressure was higher in low-income countries compared to middle-income and high-income countries.
 Extracted  http://www.who.int/gho/ncd/risk_factors/blood_pressure_text/en/

Latest Research on Hypertension and Blood Pressure

A New Treatment For High Blood Pressure

 A recent article by  Suman Varandani, highlights a potential new way of treating high blood pressure, or hypertension.

highlights
-the treatment can be done by targeting aberrant nerve signals in the carotid bodies, a small cluster of chemoreceptors and supporting cells located near the bifurcation of the carotid artery.

- new approach aims to reduce nervous system activity from a sensory organ — the carotid body — which, when activated, can cause blood pressure to rise uncontrollably.

-This treatment can offer superiority over existing medications as it lowers blood pressure directly at a common source.

"The research validated P2X3 receptors as a novel drug target for the treatment of cardiovascular disease by demonstrating that blockade of these receptors with a selective antagonist controls carotid body activity


According to Paton, the carotid bodies "sense chemicals such as oxygen in the blood. When oxygen levels fall, the carotid bodies become active and send signals to the brain that trigger increases in breathing and blood pressure."
The researchers collaborated to test whether an investigational drug candidate, MK-7624 (also known as AF-219) can stop this nervous activity from occurring, thereby lowering blood pressure.

"In healthy individuals, the carotid bodies have very low levels of activity," Paton reportedly said. "We discovered that these tiny organs become hyperactive in conditions of hypertension, generating what we have called aberrant or tonic discharge, which is sent into the brain regions controlling cardiovascular activity. In this way, changes within the carotid body may be a cause of high blood pressure and therefore represent a novel target for controlling blood pressure."
The research utilized an established animal model of human hypertension.
Researchers discovered that the energy molecule ATP (adenosine triphosphate), a recognized common signaling nucleotide, was able to persistently activate the P2X3 receptor. This protein was upregulated five times in the carotid body in hypertension.
-Blood pressure fell significantly in hypertensive rats after the blocking of this receptor in the carotid body with MK-7264/AF-219.
-unlike carotid body removal, the drug did not render the carotid body inoperable,
-it normalized its activity levels to those found in a normotensive state.


Paton states that this approach may be the first novel anti-hypertensive treatment strategy in more than 15 years, and perhaps the first directed at a root cause of excessive sympathetic discharge to cardiovascular end-organs.
extracted from 
http://www.medicaldaily.com/blood-pressure-pregnancy-cardiovascular-risks-metabolic-syndrome-390724

Prehypertension in pregnancy

Pregnant Women Whose Blood Pressure Rises During Pregnancy 6.5 Times More Likely To Devolop Metabolic Syndrome
New research on hypertension  has revealed that pregnant women with prehypertension have increased cardiovascular risk and are more likely to develop metabolic syndrome after giving birth

 - prehypertension — a condition in which blood pressure numbers are higher than normal but not high enough to be considered full-on hypertension.

- People with a systolic blood pressure (pressure in the arteries when the heart beats) of 120 to 139 mm/Hg and a diastolic pressure (pressure between heart beats, when the heart rests) of 80 to 89 mm/Hg are diagnosed with prehypertension. .
-Prehypertension in pregnancy has been linked to increased health risks after giving birth
 
Researchers found that prehypertensive pregnant women are 6.5 times more likely than those with normal blood pressure to develop metabolic syndrome — a group of conditions, such as high blood pressure, high blood sugar, and abnormal cholesterol levels, which increase risk of heart disease, stroke, and diabetes after giving birth.

methodology

Data collected from 507 Chinese women with uncomplicated pregnancies, no history of hypertension ,and normal blood sugar and cholesterol. The women underwent seven or more blood pressure measurements during their pregnancies, along with other tests typically used to monitor pregnancy, including weight measurements and fetal ultrasounds. They continued taking tests once every few months for a year-and-a-half after giving birth.
The study participants were grouped into three categories based on their blood pressure levels: those whose blood pressure remained on the lower end of normal throughout pregnancy (34 percent), those whose blood pressure hovered around midpoint-normal (52 percent), and those whose readings trended in the higher end of normal or prehypertensive (13 percent). In the statement, researchers said that a series of measurements during a woman’s lifetime did not predict risk of metabolic syndrome, but that patterns of repeated elevations over the course of a pregnancy did.
"Blood pressure measurements are already done as a matter of routine and cost-effective checkups during pregnancy, so our findings underscore this tool's potential to gauge a woman's post-partum cardiovascular risk," Niu said. "Early identification of metabolic risk factors and implementation of lifestyle modifications may help delay the onset of cardiovascular disease that would present itself 20 to 30 years after delivery."
In other words, pregnancy can be seen as a cardiovascular stress test for women in the sense that it can “reveal underlying disturbances in blood pressure regulation, glucose, and cholesterol metabolism,” researchers wrote in a news release.  If these three areas are plagued by abnormalities, then they are likely to have disrupted cardiovascular functions, which can eventually lead to cardiovascular disease.
Prehypertension doesn’t only put the mother at risk.
Past research has found that pregnant women who experience higher blood pressure than normal or persistent blood pressure elevations in the upper ranges are more likely to give birth to an underweight or stillborn baby.
extracted from
http://www.medicaldaily.com/high-blood-pressure-now-more-common-poorer-countries-why-it-should-be-public-394184

Hypertension and the developing world

New study published in the journal Circulation estimates that over a billion adults worldwide now have high blood pressure, and that the problem is only getting worse in countries that have the fewest resources to combat it.
methodology
Data from more than 100 earlier population studies taken from 90 countries from 1995 to 2014 was analysed.
- calculated that 1.39 billion adults, or just under one-third of the adult population worldwide, had hypertension in 2010.
highhlights
- adults living in low- or middle-income countries were more likely to have high blood pressure than were adults living in wealthier countries
-Overall, 28.5 percent of adults in high-income countries, or 349 million, had high blood pressure, compared to 31.5 percent, or 1.04 billion, of adults living in poorer areas.


-From 2000 to 2010, the percentage of adults with the condition living in high-income countries decreased 2.6 percent, but increased 7.7 percent among adults in low- and middle-income countries.
- 67 percent of adults in high-income countries received treatment in 2010, a nearly 10 percent increase from 2000, only 29 percent of adults elsewhere did so the same year, with a more meager 4 percent increase since 2000.
-The same trend could be seen with regards to awareness and blood pressure control.
"Healthcare systems in many low- and middle-income countries are overburdened and do not have the resources to effectively treat and control hypertension,
-hypertension is symptomless and many people in low- and middle-income countries do not have access to screenings or regular preventative medical care, it is often underdiagnosed."

The extra stress that high blood pressure adds to the body places it at greater risk for more chronic and debilitating health problems, most notably cardiovascular and kidney disease, according to Dr. Katherine T. Mills. 


- Mills suggests focus should be spent on driving down hypertension rates in the more impoverished areas of the world as well as in better-off countries. 
-Mills calls for hypertension to be a public health priority in low- and middle-income countries to prevent future cardiovascular and kidney disease, and associated costs to society.
extracted from 


http://www.medicaldaily.com/high-blood-pressure-now-more-common-poorer-countries-why-it-should-be-public-394184