This document discusses hypertension (high blood pressure) prevalence, complications, treatment benefits, and control rates in various countries. It reports that over 50 million Americans have high blood pressure, the leading cause of stroke, heart disease and kidney failure. Treating hypertension can significantly reduce risks of these conditions. However, control rates remain low, even in countries where diagnosis and treatment rates are higher. Later guidelines recommend starting treatment with ACE inhibitors, ARBs, calcium channel blockers or thiazide diuretics depending on patient factors.

4. 10 20 30 40 50 60
High BP
CAD
CHF
Stroke
Other
50,000,000
12,200,000
4,600,000
4,400,000
2,800,000
Prevalence (millions)
BP=blood pressure, CAD=coronary artery disease, CHF=congestive heart failure
American Heart Association® . 2000 Heart and Stroke Statistical Update. 1999.
(24%)

5. Eyes
• Retinopathy
Kidneys
• Nephropathy
Vasculature
• Peripheral arterial
disease
Cerebral
• Stroke
• Transient ischemic
attack
Heart Disease
• Angina
• Myocardial infarction
• Left ventricular
hypertrophy
• Heart failure
• Coronary revascularization
From Joint National Committee on Prevention, Detection, Evaluation, and
Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413-2446.

6.  Sustaining a 12 mmHg reduction in SBP over 10 years will
prevent one death for every 11 patients treated with Stage I
HTN with additional CVD risk factors
 Why treat hypertension?
◦ 35-40%  in stroke morbidity and mortality
◦ 20-25%  CAD events
◦ 21%  vascular mortality
◦ 52%  in CHF
◦ 35%  in LVH

7. Country Diagnosed
Hypertensive Aware Treated Controlled
US 24% 42% 52% 24%
UK 19% 63% 50% 30%
France 41% 79% 59% 24%
Germany 53% 12% 32% 22%
Canada 22% 59% 40% 16%
Italy 58% 79% 51% 19%
China 14% 26% 12% 3%
Chockalingam, Am J Hypertens, 1998; Chamontin et al, Am J Hypertens, 1998; Marques-Vidal et al, Q J Med, 1997; Trenkwalder et al, J Hypertens, 1994;
Vincenzi et al, G Ital Cardiol, 1992; Colhoun et al, J Hypertens, 1998; Franklin et al, Hypertension, 2001; Tao et al, Chin Med J, 1995.

16. Bisoprolol
Bloqueante beta-adrenérgico altamente
cardioselectivo, con acción receptores β-1 .
Escasa afinidad por los receptores β-2 de la
musculatura lisa bronquial y vascular,
así como por los receptores β-2 implicados en la
regulación metabólica.

20. USADA guide to prohibited classes of substances and prohibited methods of doping
. Retrieved October 2001, from http://www.usantidoping.org/prohibited_sub/guide.asp.

24. Lancet. 2005;366:1545-53.

34. Age under
55 years
Aged over 55 years or
black person of African
or Caribbean family
origin of any age
A C
A + C
A + C + D
Resistant hypertension
A + C + D + consider further
diuretic or alpha- or
beta-blocker
Consider seeking expert advice
Key
A – ACEI or
ARB
C – CCB
D – Thiazide
like diuretic

42. Hypertension
Volume 59(4):893-898
March 14, 2012

45. Risk/Benefit Assessment of β-Blockers
and Diuretics Precludes Their Use for
First-Line Therapy in Hypertension
by Franz H. Messerli, Sripal Bangalore, and Stevo Julius
Circulation
Volume 117(20):2706-2715
May 20, 2008
Copyright © American Heart Association

46. Figure 6. Risk of new-onset diabetes
mellitus with antihypertensive treatment.
Messerli F et al. Circulation 2008;117:2706-2715
Copyright © American Heart Association

50. ARCH INTERN MED/VOL 170 (NO. 10), MAY 24,
2010

59. Ankle-brachial index in the 2 treatment groups at baseline
and after the 48 week treatment period.
Espinola-Klein C et al. Hypertension 2011;58:148-154
Copyright © American Heart Association