Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T19:30:15.906Z Has data issue: false hasContentIssue false

13 - Hypertension and stroke

from Part III - Disease prevention

Published online by Cambridge University Press:  21 August 2009

By
Jo Ann Rosenfeld
Edited by
Jo Ann Rosenfeld
Jo Ann Rosenfeld
Affiliation:
Johns Hopkins School of Medicine, Baltimore, MD
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
Get access

Summary

Case: M.M. is a 54-year-old obese woman who has not seen a physician in two years. She has a history of hypertension and high cholesterol. She works full time as an accountant for a medium-sized firm and has spent all her spare time for the past two years caring for her mother, who died two years after being incapacitated by a stroke. She has two married daughters who live across the country. She wants to control her hypertension so she doesn't end up like her mother and as a burden to her children.

Introduction

Hypertension has been termed the “silent killer.” Working with women to control their hypertension can positively affect their future health. Treating and controlling hypertension can decrease the risks of heart disease, death, myocardial infarction (MI), kidney disease, and stroke. Yet, fewer than half of individuals with hypertension receive treatment, and of those who are under treatment fewer than half are controlled well. Strokes may be prevented primarily or secondarily in individuals with certain risk factors, but the treatment is not completely effective.

Hypertension

Impact

Approximately one-fifth of adults over the age of 40 have high blood pressure. Hypertension is the most common cause of stroke in the UK and the most common cause of renal failure in the USA. Women are more likely than men to have hypertension, and the risk of hypertension increases with age.

Uncontrolled hypertension affects health profoundly negatively, and improving hypertension improves health.

Keywords

alcohol abuseconcomitant diseasesCushing's syndromediabetesparenchymal diseaselifestyle changespheochromocytomahypertensionprimary aldosteronismstroke
Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
 , pp. 225 - 234
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brown, M. J.Science, medicine and the future. Hypertension. Br. Med. J. 1997; 314:1258CrossRefGoogle ScholarPubMed
O'Rorke, J. E. and Richardson, W. S.Evidence based management of hypertension: what to do when blood pressure is difficult to control. Br. Med. J. Br. Med. J.; 322:1229–32CrossRefGoogle Scholar
Mercuro, G., Sonco, S., Pilia, I., et al.Effects of acute administration of transdermal estrogen on postmenopausal women with systemic hypertension. Am. J. Cardiol. 1997; 80:652–7CrossRefGoogle ScholarPubMed
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH publication no. 98-4080. Bethesda, MD: National Institutes of Health; 1997
Little, P., Barnett, J., Barnsley, L., et al.Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure. Br. Med. J. 200; 325:254–7CrossRef
Gueyffier, F., Boutitie, F., Boissel, J. P., et al.Effect of antihypertensive drug treatment on cardiovascular outcomes in women and men. Ann. Intern. Med.Ann. Intern. Med.; 126:761–7CrossRef
Huang, Z., Willett, W. C., Mason, J. E., et al.Body weight, weight change and the risk for hypertension in women. Ann. Intern. Med.Ann. Intern. Med.; 128:81–8CrossRef
Geleijnse, J. M., Wetteman, J. C., Back, A. A., Breijen, J. H. and Grobee, D. E.Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension. Br. Med. J. Br. Med. J.; 309:436–40CrossRefGoogle Scholar
Ramsay, L., Williams, B., Johnston, G., et al.Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. J. Hum. Hypertens. 1999; 13:569–92CrossRefGoogle ScholarPubMed
Williams, B.Drug treatment of hypertension. Br. Med. J. USA 2003; 322:127–9Google Scholar
Mulrow, C. D. and Pignone, M.Evidence based management of hypertension: what are the elements of good treatment for hypertension?Br. Med. J. 2001; 322:1107–9CrossRefGoogle Scholar
Bosch, J., Yusuf, S., Pogue, J., et al.Use of ramipril in preventing stroke: double blind randomised trial. Br. Med. J. 2002; 324:699–702CrossRefGoogle ScholarPubMed
Mogensen, C. E., Neldam, S., Tikkanen, I., et al.Randomised controlled trial of dual blockade of renin–angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. Br. Med. J. 2000; 321:1440–44CrossRefGoogle ScholarPubMed
Hansson, L., Lindholm, L. H., Ekbom, T., et al.Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity. The Swedish Trial in Old Patients with Hypertension-2 study. Lancet 1999; 354:1751–6CrossRefGoogle ScholarPubMed
Collaboration Blood Pressure Lowering Treatment Trialists. Effects of angiotensin converting enzyme inhibitors, calcium antagonists and other blood pressure lowering drugs on mortality and major cardiovascular morbidity. Lancet 2000; 356:1955–64
The ALLHAT Officers and Co-ordinators for the ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomly assigned to doxazosin vs chlorthalidone: the antihypertensive and lipid lowering treatment to prevent heart attack trial (ALLHAT). J. Am. Med. Assoc. 2002; 283:1967–75
Williams, B.Drug treatment of hypertension. Br. Med. J. 2003; 326:61–2CrossRefGoogle ScholarPubMed
Pope, J. E., Anderson, J. J. and Felson, D. T.A metaanalysis of the effects of non-steroidal anti-inflammatory drugs on blood pressure. Arch Intern. Med. 1992; 153:477–84CrossRefGoogle Scholar
Johnson, A. G., Nguyen, T. V. and Day, R. O.Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Ann. Intern. Med. 1994; 121:289–90CrossRefGoogle ScholarPubMed
Gubitz, G. and Sandercock, P.Prevention of ischaemic stroke. Br. Med. J. 2000; 321:1455–9CrossRefGoogle ScholarPubMed
Alberts, M. tPA in acute ischemic stroke. United States experience and issues for the future. Neurology 1988; 51 (supp 3):53–5SCrossRefGoogle Scholar
Lees, K. R., Bath, P. M. W. and Naylor, A. R.ABC of arterial and venous disease: secondary prevention of transient ischaemic attack and stroke. Br. Med. J. 2000; 320:991–4CrossRefGoogle ScholarPubMed
Gorelick, P. B., Sacco, R. L., Smith, D. B.et al.Prevention of a first stroke. A review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. J. Am. Med. Assoc. 1999; 281:1112–20CrossRefGoogle Scholar
Hart, R. G., Benavente, O., McBride, R. and Pearce, L. A.Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann. Intern. Med. 1999; 131:492–501CrossRefGoogle ScholarPubMed
PROGRESS Management Committee. Blood pressure lowering for the secondary prevention of stroke: rationale and design of PROGRESS. J. Hypertens. 1996; 14 (supp 2):41–6SCrossRef
Antiplatelet Trialists' Collaboration. Collaborative overview of randomised trials of antiplatelet therapy. I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Br. Med. J. 1994; 308:81–106CrossRef
The Stroke Prevention in Reversible Ischaemia Trial (SPIRIT) Study Group. A randomised trial of anticoagulant versus aspirin after cerebral ischemia of presumed arterial origin. Ann. Neurol. 1997; 42:857–65CrossRef
Hart, R. G., Benavente, O., McBride, R. and Pearce, L. A.Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta analysis. Ann. Intern. Med. 1999; 131:492–501CrossRefGoogle ScholarPubMed
Cina, C., Clase, C. and Haynes, R. Carotid endarterectomy for symptomatic stenosis. In: Cochrane Library, Issue 3. Oxford: Update Software; 1999

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×