The main indication for echocardiography is evaluation for end-organ damage in a patient with borderline-high blood pressure. Therefore, the presence of left ventricular hypertrophy despite normal or borderline-high blood pressure measurements requires antihypertensive therapy. Echocardiography may detect left atrial dilatation, left ventricular hypertrophy, and diastolic or systolic left ventricular dysfunction more frequently than electrocardiography.
Hypertension may be primary, which may develop as a result of environmental or genetic causes; or secondary, which has multiple etiologies including renal, vascular, and endocrine causes. Primary or essential hypertension accounts for 90%-95% of adult cases, and secondary hypertension accounts for 5%-10% of cases.
Ambulatory or home blood pressure monitoring provides a more accurate prediction of CVD risk than do office blood pressure readings. "Nondipping" is the loss of the usual physiologic nocturnal drop in blood pressure and is associated with increased CVD risk.
According to the 2017 Guideline for High Blood Pressure in Adults from the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Clinical Practice Guidelines, initial first-line therapy for stage 1 hypertension includes thiazide diuretics, calcium-channel blockers, and ACE inhibitors or angiotensin blockers. For patients with stage 2 hypertension and average blood pressure of 20/10 mm Hg above the target, two first-line drugs of different classes are recommended.
For more on hypertension, read here.
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Cite this: Yasmine S. Ali. Fast Five Quiz: How Much Do You Know About Cardiovascular Risk Factors? - Medscape - Apr 13, 2018.
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