This document summarizes the history and key milestones in understanding and treating hypertension. It discusses early physicians like William Harvey who discovered blood circulation and Stephen Hales who first measured blood pressure. Important developments include the mercury sphygmomanometer in 1896, Korotkoff sounds in 1905, and the term "essential hypertension" being coined in 1911. It then outlines landmark studies and drugs developed to treat hypertension over the 20th century, including the Framingham Heart Study and classes of drugs like beta blockers, ACE inhibitors, and concludes with a discussion of modern clinical practice guidelines.

1. Historical Milestones in
Hypertension and its Management
Dr. Nagula Praveen
MD,DM
Associate Professor of Cardiology
Osmania General Hospital
Hyderabad

2. Study the past, if you would define the future.
- Confucius

3. WILLIAM HARVEY
English Physician
Circulation of the Heart
and Blood
1628
STEPHEN HALES
English Clergyman
First person to
measure blood pressure
1733
RIVA ROCCI
Italian
Mercury sphygmomanometer
1896
N.C. KOROTKOFF
Russian
1905
reported on the
method of
auscultation of
brachial artery, the
method which is
widely used today.

4. The term essential hypertension ('Essentielle Hypertonie')
was coined by Eberhard Frank in 1911 to describe
elevated blood pressure for which no cause could be found.
Thomas Young -
Hypertension as a disease 1808
Malignant hypertension, a term used to describe severe
hypertension which eventually resulted in death, was first
used by The Mayo Clinic in 1928.

5. “Hypertension may be an important compensatory
mechanism which should not be tampered with, even were it
certain that we could control it”.
–Paul Dudley White, Father of Preventive Cardiology.

6. FRANKLIN D. ROOSEVELT
The 32nd President of the United States

7. President Franklin D. Roosevelt was given a clean bill
of health by his physician even when his BP was
recorded as ~220/120.
A few years later while at Yalta, Winston Churchill’s
personal physician noted in his diary that President
Roosevelt “appeared to be have had signs of
‘hardening of the arteries disease’ and had a few
months to live.”
President Roosevelt ultimately had a fatal
hemorrhagic stroke 2 months later, and his death
brought hypertension’s potential as a deadly to the
limelight.
Three years after Roosevelt’s death, the pivotal
National Heart Act was signed into law by President
Truman. The Act created the path for the study of
heart diseases and resulted in several studies
including the Framingham Heart Study.

8. Timeline of Hypertension History

9. Schematic model of the evolution of understanding and
approaches to hypertension in the 20th century.

10. First sphygmograph

13. Miguel Ondetti and David
Cushman, 1975 developed
Captopril, the first of a new class of
drugs known as angiotensin
converting enzyme (ACE) inhibitors.
James Whyte Black, 1962
Developed propranolol, a beta blocker
used for the treatment of heart disease

14. I wish I had my betablockers handy
-Dr. James Black, 1988

16. Evolution of Blood Pressure Clinical Practice
Guidelines

19. Conclusion:
This study showed the clinical efficacy, safety and acceptability of the
perindopril/indapamide/amlodipine SPC in patients with grade 2/3 hypertension inadequately
controlled with two drug therapy. The clinical effectiveness was observed in more than 96%
patients. The benefit of SPC therapy in hypertension control was reconfirmed in this study.

20. Hypertension Screening on Occasion
of World Hypertension Day 2022
• Of the approximately 4500 patients screened, around 800+
patients were screened at OGH, Hyderabad.
3565
922
Males Females

21. 21
846
1723 1918
0
500
1000
1500
2000
2500
Hypertension
Normal
Pre
Hypertension
Hypertension
42.74%
38.39%
17.45%
Prehypertension is defined as a systolic pressure from 120-139 mmHg
and diastolic 80-89 mmHg

22. 22
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
BMI
≥24.0 kg/m2 (Over weight/Obesity)
> = 24.0(over
weight/Obesity)
70.8 %

23. 23
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Diabetes
33 % are Diabetics