Defining, treating borderline hypertension continues to challenge clinicians, researchers

Article Abstract:

Hypertension, or high blood pressure, is in some ways different than many diseases treated by the practicing physician. Hypertension has no symptoms, and treatment is administered only to prevent the strokes, kidney failure, and heart failure which are likely to result from long-term hypertension. While most physicians would agree that serious high blood pressure demands immediate medical treatment, there is no consensus on what treatment is most appropriate for people with borderline hypertension. Indeed, there is not even complete consensus about what blood pressures are 'borderline' and what pressures are real hypertension. Generally, blood pressure is quoted as two numbers, for example 120 over 70, which indicate the high point and low point of the pressure during an individual pulse. Epidemiologists studying the distribution of medical problems in the population have labelled as borderline a high-point, or systolic, pressure between 140 and 160 and a diastolic pressure between 90 and 95. Many physicians consider this to be hypertensive, and not merely borderline. It is not easy to identify the members of the population who might have hypertension, particularly in the more mild ranges. Blood pressure varies during the course of the day, and a single measurement may not be reliable for identifying the presence or extent of a problem. Some physicians have suggested that patients be tested with special 24-hour-a-day monitors, devices which are now used predominantly for research only. It is estimated that from 20 to 25 percent of all people with high blood pressure are unaware of this problem. Few physicians would recommend that patients with borderline hypertension be treated with drugs. The best method is to reduce weight, stop smoking, reduce alcohol consumption, and make other lifestyle changes. However, physicians have also learned over the years that achieving lifestyle changes is difficult for most patients and is difficult for physicians to implement. People most likely to have borderline hypertension and who are at the greatest risk of developing overt hypertension may be identified on the basis of several important factors. The most significant risk factors are male sex, black race, obesity, smoking, family history of heart problems, excessive serum cholesterol and other fats, and diabetes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Hypertension, Measurement, Blood pressure, Blood pressure measurement, Mild hypertension

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Hispanic HANES takes long look at Latino health

Article Abstract:

The Hispanic Health and Nutrition Examination Survey (HHANES), carried out between 1982 and 1984, is beginning to yield valuable insights concerning the health of Cuban Americans, Mexican Americans, and Puerto Ricans who live in the US. Hispanics will soon constitute the largest minority group in the country, and they are particularly afflicted with diabetes, gallstones, obesity, and high blood pressure. Diabetes is high not only among Mexican Americans, but also among Puerto Ricans, a surprising finding. A greater proportion of Puerto Ricans than members of the other two subgroups have chronic bronchitis, and more Puerto Rican women are smokers. In the San Antonio Heart Study, Mexican American men with cardiovascular disease were found to have a lower death rate than non-Hispanic white males, for reasons unknown; their mortality is lower than their risk factors predict. Other health-related differences between subgroups are illustrated. Sociocultural factors may play an important role in the outcome of coronary heart disease among Mexican American men. These men had an increased prevalence of angina pectoris (severe pain resulting from insufficient blood supply to the heart), usually associated with a risk for heart attack. Analysis of other health data suggests that, as Mexican Americans remain in the US, their health worsens: infant mortality is lower among Mexican Americans born in Mexico than among Mexican Americans born in the US. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Statistics, Hispanic Americans

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