High Blood Pressure
(Hypertension)
Revising Medical Author: John P. Cunha, DO, FACOEP
Revising Medical Editor: Jay W. Marks, MD
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Diuretics Still Best Treatment for High Blood Pressure
Nov. 18 (HealthDay News) -- Tried-and-true diuretics maintain their status as the best first-line treatment in older men and women with high blood pressure, new research concludes.
The thiazide-type diuretic chlorthalidone outshone three other treatments -- a calcium channel blocker, an ACE inhibitor and an alpha-receptor blocker -- in most areas, especially in lowering the incidence of stroke and heart failure, according to the most current data from a large ongoing study known as ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).
"We believe thiazide-type diuretics should still be preferred," said study investigator Dr. William Cushman, professor and chief of preventive medicine at the Veterans Affairs Medical Center in Memphis, Tenn., at a news conference on the findings Wednesday at the annual meeting of the American Heart Association (AHA) in Orlando, Fla.
"The message is...
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What is high blood pressure?
High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.
The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.
An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.
It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.
The American Heart Association estimates high blood pressure affects approximately one in three adults in the United States - 73 million people. High blood pressure is also estimated to affect about two million American teens and children, and the Journal of the American Medical Association reports that many are under-diagnosed. Hypertension is clearly a major public health problem.
Next: How is the blood pressure measured? »
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