Management of Hypertension and Cardiovascular Disease Prevention
Cardiovascular diseases, including ischaemic heart disease and stroke are the leading causes of death worldwide. In Europe and in countries with developed economies they are responsible for more than 40% of yearly deaths1. High blood pressure, the major cardiovascular risk factor, has also been found the leading cause of mortality worldwide, and ranks high also in developing regions of the world2. It has been calculated that 972 millions of the world population (333 in developed regions and 639 in developing regions) had high blood pressure in 2000, but these figures are expected to increase by 2025, when there will be 1.56 billion hypertensives of whom more than 1 billion in the developing parts of the world3.
The cost of cardiovascular diseases is very high, both to the individual patient and to societies. It has been calculated that the estimated direct and indirect costs of stroke, the most ominous consequence of hypertension, have been of US $ 53.6 billion only in the USA during 2004.
Cardiovascular diseases, including stroke, are preventable diseases, since some of its most important causative factors, such as hypertension and tobacco smoking, can be corrected. Antihypertensive treatment has been one of the most outstanding successes of medicine in the second half of the 20th century. The Journal of Hypertension, the official organ of both the International and the European Societies of Hypertension, is dedicated to original basic and clinical research on hypertension and its cardiovascular and renal complications.
In the last 15 years it has published guidelines prepared by these scientific Societies and the World Health Organization, and thus contributed to spreading evidence based recommendations for health prevention. The most recent of these guidelines, those prepared jointly by the European Society of Hypertension and the European Society of Cardiology, have been published in the June 2007 issue of the Journal of Hypertension4, and summary guidelines for practicing physicians have appeared on the August 2007 issue of the Journal5. The summary guidelines are freely available from the website of the Journal of Hypertension.
Alberto Zanchetti
Centro di Fisiologia Clinica e Ipertensione, University of Milan,Istituto Auxologico Italiano, Milan
References
1. WHO, Evidence, Information and Policy, 2003
2. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ, Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347-1360.
3. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217-223.
4. The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). 2007 Guidelines for the Managment of Arterial Hypertension. J Hypertens 2007; 25: 1105-1187
5. ESH-ESC Task Force on the Management of Arterial Hypertension. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension. J Hypertens 2007; 25: 1751-1762.
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