New Perspectives for Hypertension Management: Progress in Methodological and Technological Developments.
Gianfranco ParatiAlexandra GoncalvesDavid SoergelRosa Maria BrunoEnrico Gianluca CaianiEva GerdtsFelix MahfoudLorenzo MantovaniRichard J McManusPaola SantaluciaThomas KahanPublished in: European journal of preventive cardiology (2022)
Hypertension is the most common and preventable risk factor for cardiovascular disease (CVD), accounting for 20% of deaths worldwide. However, 2/3 of people with hypertension are undiagnosed, untreated, or under treated. A multi-pronged approach is needed to improve hypertension management. Elevated blood pressure (BP) in childhood is a predictor of hypertension and CVD in adulthood; therefore, screening and education programs should start early and continue throughout the lifespan. Home BP monitoring can be used to engage patients and improve BP control rates. Progress in imaging technology allows for the detection of preclinical disease, which may help identify patients who are at greatest risk of CV events. There is a need to optimise the use of current BP control strategies including lifestyle-modifications, antihypertensive agents, and devices. Reducing the complexity of pharmacological therapy using single-pill combinations can improve patient adherence and BP control, and may reduce physician inertia. Other strategies that can improve patient adherence include education and reassurance to address misconceptions, engaging patients in management decisions, and using digital tools. Strategies to improve physician therapeutic inertia, such as reminders, education, physician-peer visits, and task-sharing may improve BP control rates. Digital health technologies, such as telemonitoring, wearables, and other mobile health platforms, are becoming frequently adopted tools in hypertension management, particularly those that have undergone regulatory approval. Finally, to fight the consequences of hypertension on a global scale, healthcare system approaches to cardiovascular risk factor management are needed. Government policies should promote routine BP screening, salt-, sugar-, and alcohol-reduction programs, encourage physical activity, and target obesity control.
Keyphrases
- blood pressure
- end stage renal disease
- healthcare
- cardiovascular disease
- physical activity
- public health
- ejection fraction
- newly diagnosed
- chronic kidney disease
- hypertensive patients
- heart rate
- primary care
- type diabetes
- high resolution
- case report
- mental health
- quality improvement
- adipose tissue
- peritoneal dialysis
- clinical practice
- risk assessment
- stem cells
- weight loss
- climate change
- sleep quality
- photodynamic therapy
- glycemic control
- early life
- transcription factor
- quantum dots
- young adults
- human health
- sensitive detection
- high fat diet induced