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• W2184014010 abstract "1 Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN. Correspondencia para: Rajiv Agarwal. Indiana University and VAMC, 1481 West 10th Street, Indianapolis, IN 46202. Fone: 317-988 2241. Fax: 317-988 2171. E-mail: ragarwal@iupui.edu. Recebido: 10/1/2008 Aceito: 5/2/2008 A DEADLY EPIDEMIC Over one billion people worldwide are afflicted with hypertension1. Prevalence of hypertension in Brazil varies depending on region, but ranges from 22% to 44%2. The impact of hypertension on morbidity and mortality is staggering. Hypertension increases the risk of left ventricular hypertrophy3, triples the risk of stroke4, and increases the risk of developing end-stage renal disease by fivefold5. Even high-normal blood pressure (BP) nearly triples the risk of major cardiovascular events6. In fact, for every 20/10 mmHg increase in systolic/diastolic BP above 115 x 75 mmHg, cardiovascular mortality doubles7. Hypertension remains the single factor responsible for the most deaths worldwide at over 7 million deaths annually8. In Brazil, deaths from cardiovascular disease have outnumbered all other causes of death for over forty years and accounts for almost 1/3 of all deaths2. Although great progress has been made in some areas of the world, mortality in Brazil from cerebrovascular and coronary artery disease has shown little improvement2. Given the scope of this global epidemic, it is astounding to discover that patients and physicians do a poor job diagnosing and managing the disease. In the United States, between 2003 and 2004, just over half of all hypertensive patients were even being treated for the disease and only 33% were controlled9. In Brazil, less than 25% of surveyed physicians even recognized a BP ≥ 140 x 90 mmHg as hypertensive and less than 20% attempt to achieve the Brazilian Guidelines on Hypertension10. Benefits from controlling hypertension have been unequivocally shown in multiple studies. Lower BP has been associated with slower loss of kidney function11, patient survival in diabetics, myocardial infarction as well as all-cause mortality6,12-14. Treating hypertension has shown to lower the rate of GFR decline15,16 and decrease several major cardiovascular events17-21. Hypertension is clearly a disease of great burden to society but one that can be effectively treated with resultant reduction in morbidity and mortality. Given the poor control status, improvements in diagnosing and managing this epidemic are needed. Improved management begins with correctly diagnosing the disease process at hand, which in turn requires familiarity with several conditions and definitions." @default.
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• W2184014010 date "2008-01-01" @default.
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• W2184014010 title "Home blood pressure monitoring for detection and control of hypertension: a call for action" @default.
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