EC Microbiology

Introduction: Every year, approximately 2 million new cases of hypertension are diagnosed. On a worldwide scale, approximately 1 billion people are hypertensive, and it is projected to reach a mark of 1.56 billion by the end of 2025. Hypertension is the most prominent reason for death and the second most common reason for disability-adjusted life. Hypertension is the leading cause of strokes, including cerebral and subarachnoid hemorrhage, heart diseases, kidney-related diseases, and macrovascular diseases. A good understanding of lifestyle modifications and the usage of pharmacological agents in a supervised manner can help reduce hypertension and let the patients achieve an appropriate blood pressure goal. Hypertension is the number one modifiable risk factor that can be easily controlled through lifestyle modifications and pharmacological options reducing the life-threatening complications associated with it.

Aim of Work: The present study aims to review the management of hypertension.

Methodology: The review is a comprehensive research of PUBMED and Google scholar from the year 1999 to 2022.

Conclusion: Hypertension is a modifiable global epidemic. If not treated at the right time, hypertension can lead to many risk factors leading to morbidity and mortality. The first step in hypertension management should be lifestyle modification which has proven to reduce blood pressure values to a great extent. Most patients require a pharmacological intervention which should be initiated at the initial stage to increase efficiency and reduce side effects. Monotherapy might not be sufficient for some patients, and they require a combination of drugs to control hypertension. A thorough management technique for hypertension includes a good screening, initiation of the pharmacological and non-pharmacological treatment plan at the right time, good communication between the patient and the healthcare worker, and good patient compliance.

Keywords: Hypertension; Diuretics; DASH Diet; Vasodilator; Beta-Blockers

1. Chobanian AV., et al. “Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure”. Hypertension6 (2003): 1206-1252.
2. Alcocer L and Cueto L. “Hypertension, a health economics perspective”. Therapeutic Advances in Cardiovascular Disease 3 (2008): 147-155.
3. Shimamoto K., et al. “The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2014)”. Hypertension Research: Official Journal of the Japanese Society of Hypertension 4 (2014): 253-390.
4. Spurgeon D. “NIH promotes use of lower cost drugs for hypertension”. BMJ: British Medical Journal7439 (2004): 539.
5. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. “The 6th Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure”. Archives of Internal Medicine 157 (1997): 2413-2446.
6. Forman JP and Brenner BM. “Hypertension' and 'microalbuminuri': the bell tolls for thee”. Kidney International 1 (2006): 22-28.
7. Bray GA., et al. “A further subgroup analysis of the effects of the DASH diet and three dietary sodium levels on blood pressure: results of the DASH-Sodium Trial”. The American Journal of Cardiology 2 (2004): 222-227.
8. Erdem Y., et al. “The effect of intermittent fasting on blood pressure variability in patients with newly diagnosed hypertension or prehypertension”. Journal of the American Society of Hypertension 1 (2018): 42-49.
9. Ghadieh AS and Saab B. “Evidence for exercise training in the management of hypertension in adults”. Canadian Family Physician 3 (2015): 233-239.
10. Verma N., et al. “Non-pharmacological management of hypertension”. The Journal of Clinical Hypertension 7 (2021): 1275-1283.
11. Davis BR., et al. “Rationale and design for the antihypertensive and lipid lowering treatment to prevent heart attack trial (ALLHAT)”. American Journal of Hypertension 4 (1996): 342-360.
12. Saklayen MG. “Which diuretic should be used for the treatment of hypertension?” American Family Physician 4 (2008): 444.
13. Rahman M., et al. “Prevalence of and factors associated with hypertension according to JNC 7 and ACC/AHA 2017 guidelines in Bangladesh”. Scientific Reports 1 (2021): 1-10.
14. Bedrouni W., et al. “Timing of statistical benefit of mineralocorticoid receptor antagonists among patients with heart failure and post-myocardial infarction”. Circulation: Heart Failure 10 (2022): e009295.
15. Pitt B., et al. “Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction”. New England Journal of Medicine 14 (2003): 1309-1321.
16. Heran BS., et al. “Blood pressure lowering efficacy of angiotensin receptor blockers for primary hypertension”. Cochrane Database of Systematic Reviews 4 (2008).
17. Parving HH., et al. “Aliskiren combined with losartan in type 2 diabetes and nephropathy”. New England Journal of Medicine 23 (2008): 2433-2446.
18. Blood Pressure Lowering Treatment Trialists' Collaboration. “Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials”. The Lancet 9246 (2000): 1955-1964.
19. Nguyen Q., et al. “Hypertension management: an update”. American Health and Drug Benefits 1 (2010): 47.
20. Dayyih WA. Impact of Beta-Blockers (Bisoprolol) and Calcium Channel Blockers (Amlodipine) on Glycated Hemoglobin (HbA1c) in Induced Diabetes Mellitus Type II in Rats (T2DM) (Doctoral dissertation, University of Petra) (2019).
21. Carlberg B., et al. “Atenolol in hypertension: is it a wise choice?” The Lancet 9446 (2004): 1684-1689.
22. Wiysonge CS., et al. “Cochrane corner: beta-blockers for hypertension”. Heart 4 (2018): 282-283.
23. Furberg CD., et al. “Clinical implications of recent findings from the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT) and other studies of hypertension”. Annals of Internal Medicine 12 (2001): 1074-1078.
24. Ernst ME., et al. “All thiazide‐like diuretics are not chlorthalidone: putting the ACCOMPLISH study into perspective”. The Journal of Clinical Hypertension 1 (2009): 5.