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Hypertension (High Blood Pressure)

Hypertension, or high blood pressure is a chronic, progressive condition that affects more than 65 million Americans with more than 2 million new cases diagnosed annually. Due to its prevalence and profound impact on health, the US preventive services task force recommends routine screening for hypertension in the general adult population. Although it is often asymptomatic, hypertension has a considerable contribution to both acute and chronic conditions. For example, acute elevations of blood pressure can cause life threatening conditions such as hypertensive emergency as well as aortic dissection. On the other hand, chronic hypertension is associated with cerebrovascular disease, coronary artery disease, peripheral vascular disease, heart failure, chronic kidney disease and more. In fact, for persons aged 40 to 70, each increment of 20 mm Hg or more doubles the risk of cardiovascular disease and when other high risk diseases are present such as diabetes, the risk is even higher. While most cases of hypertension are primary, there are some scenarios where hypertension is a manifestation of another illness and further investigation may be warranted. The first steps in treating hypertension include lifestyle modifications such as diet and exercise. When lifestyle modifications alone are not enough, medications may be required. The choice of medication should be customized to the patient with consideration of the presence of comorbidities as well as lifestyle factors and may include such agents as a diuretic, calcium channel blocker or ACE inhibitor.

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Weir MR. In The Clinic: Hypertension. Ann Intern Med. 2014 Dec 2; 161 (11)