Chronic hypertension risk factors

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2017 ACC/AHA Hypertension Guidelines

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief:Yazan Daaboul, Serge Korjian

Overview

Established risk factors for essential hypertension include old age, male gender, African American ethnicity, dyslipidemia, diabetes mellitus, smoking, increased salt intake in diet, obesity, and sedentary lifestyle. Studies are currently assessing the role of new emerging factors that might be considered as new risk factors for the development of hypertension.

Risk Factors

Several factors have been robustly associated with hypertension, particularly cardiovascular risk factors. Nonetheless, other emerging factors have been linked to an increased risk of developing hypertension in select studies.

Cardiovascular Risk Factors

  • Age: Men > 55 years, women > 65 years[1]
  • Ethnicity: African American[2]
  • Smoking: Cigarettes [3]
  • Alcohol: Excessive intake of more than 2 alcoholic drinks per day[4]
  • Dyslipidemia: Elevated total cholesterol > 190 mg/dL and/or LDL > 115 mg/dL and/or HDL < 40 mg/dL for men and 45 mg/dL for women and/or triglycerides > 150 mg/dL[1]
  • Insulin resistance: Fasting plasma glucose 102-125 mg/dL, and/or abnormal glucose tolerance test[1]
  • Known cardiovascular diseases[5]
  • Known kidney diseases[5]
  • Family history of hypertension: Paternal or maternal[6]
  • Family history of CVD: Men < 55 years and/or women < 65 years[1]
  • Diet: Low in fruits and vegetables; excessive sodium intake[7]
  • Obesity and recent weight gain: BMI ≥ 30 kg/m2[8] or waist circumference for men > 102 cm or for women > 88 cm (in Caucasian adults)
  • Sedentary lifestyle[5]

Emerging Risk Factors

References

  1. 1.0 1.1 1.2 1.3 Mancia G, Fagard R, Narkiewicz K, Redán J, Zanchetti A, Böhm M; et al. (2013). "2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension". J Hypertens. 31 (10): 1925–38. doi:10.1097/HJH.0b013e328364ca4c. PMID 24107724.
  2. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D; et al. (2001). "Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group". N Engl J Med. 344 (1): 3–10. doi:10.1056/NEJM200101043440101. PMID 11136953.
  3. Gupta PC, Ray CS (2003). "Smokeless tobacco and health in India and South Asia". Respirology. 8 (4): 419–31. PMID 14708551.
  4. Marmot MG, Elliott P, Shipley MJ, Dyer AR, Ueshima H, Beevers DG; et al. (1994). "Alcohol and blood pressure: the INTERSALT study". BMJ. 308 (6939): 1263–7. PMC 2540174. PMID 7802765.
  5. 5.0 5.1 5.2 Cuddy ML (2005). "Treatment of hypertension: guidelines from JNC 7 (the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 1)". J Pract Nurs. 55 (4): 17–21, quiz 22-3. PMID 16512265.
  6. Wang NY, Young JH, Meoni LA, Ford DE, Erlinger TP, Klag MJ (2008). "Blood pressure change and risk of hypertension associated with parental hypertension: the Johns Hopkins Precursors Study". Arch Intern Med. 168 (6): 643–8. doi:10.1001/archinte.168.6.643. PMID 18362257.
  7. Forman JP, Stampfer MJ, Curhan GC (2009). "Diet and lifestyle risk factors associated with incident hypertension in women". JAMA. 302 (4): 401–11. doi:10.1001/jama.2009.1060. PMC 2803081. PMID 19622819.
  8. Sonne-Holm S, Sørensen TI, Jensen G, Schnohr P (1989). "Independent effects of weight change and attained body weight on prevalence of arterial hypertension in obese and non-obese men". BMJ. 299 (6702): 767–70. PMC 1837623. PMID 2508915.
  9. Pilz S, Tomaschitz A, Ritz E, Pieber TR (2009). "Vitamin D status and arterial hypertension: a systematic review". Nat Rev Cardiol. 6 (10): 621–30. doi:10.1038/nrcardio.2009.135. PMID 19687790.
  10. Hazari MA, Arifuddin MS, Muzzakar S, Reddy VD (2012). "Serum calcium level in hypertension". N Am J Med Sci. 4 (11): 569–72. doi:10.4103/1947-2714.103316. PMC 3503375. PMID 23181228.
  11. Park SE, Rhee EJ, Park CY, Oh KW, Park SW, Kim SW; et al. (2012). "Impact of hyperinsulinemia on the development of hypertension in normotensive, nondiabetic adults: a 4-year follow-up study". Metabolism. doi:10.1016/j.metabol.2012.09.013. PMID 23122695.
  12. Norman M (2010). "Preterm birth--an emerging risk factor for adult hypertension?". Semin Perinatol. 34 (3): 183–7. doi:10.1053/j.semperi.2010.02.009. PMID 20494733.
  13. Hornigold RE, Golding JF, Ferner RE, Ferner RE (2011). "Neurofibromatosis 2: a novel risk factor for hypertension?". Am J Med Genet A. 155A (7): 1721–2. doi:10.1002/ajmg.a.34035. PMID 21638762.
  14. Chen K, Xie F, Liu S, Li G, Chen Y, Shi W; et al. (2011). "Plasma reactive carbonyl species: Potential risk factor for hypertension". Free Radic Res. 45 (5): 568–74. doi:10.3109/10715762.2011.557723. PMID 21323510.
  15. Feig DI (2012). "The role of uric acid in the pathogenesis of hypertension in the young". J Clin Hypertens (Greenwich). 14 (6): 346–52. doi:10.1111/j.1751-7176.2012.00662.x. PMID 22672087.
  16. Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS (2009). "Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study". Psychosom Med. 71 (3): 273–9. doi:10.1097/PSY.0b013e3181988e5f. PMID 19196807.

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