Individualized treatment for hypertension

Author: Zhang Jian et al.
Publisher:
Publishing Date: 2004-11-13
Features: China, like developed and developing countries, is facing an increasing trend of hypertensive patients. A national survey in 1991 found 90 million hypertensive patients, while the National Health Commission-led nationwide hypertension sampling survey in 1997 revealed that the standardized prevalence rate of hypertension among the population aged 15 and above in China was 11.19%, with 110 million hypertensive patients nationwide, an increase of approximately 3.5 million annually. Moreover, the incidence of hypertension continued to rise with age. However, the blood pressure measurement rate (i.e., those who had previously had their blood pressure measured) in China was only 53.5%, the awareness rate (knowing one's own blood pressure) was only 26.6%, and the medication rate among detected cases was only 24.77%. A comprehensive analysis of four clinical trials in China showed that a 9 mmHg reduction in systolic blood pressure and a 4 mmHg reduction in diastolic blood pressure could reduce strokes by 36, coronary heart disease by 3%, and total cardiovascular events by 34%.
Extensive randomized controlled clinical trial results in the West also demonstrated that a 10–14 mmHg reduction in systolic blood pressure and a 5–6 mmHg reduction in diastolic blood pressure could reduce strokes by 40, coronary heart disease by 16.7%, and total cardiovascular events by 33.3%. A quantitative analysis of a long-term study on the impact of antihypertensive treatment on the incidence and mortality of elderly patients in the United States in 2000 (including 15 trials with 21,908 elderly patients) showed that, over 5 years, the incidence and mortality of cardiovascular diseases among 1,000 participants treated with antihypertensive medication could decrease from 177 per thousand to 126 per thousand, cardiovascular disease deaths from 69 per thousand to 50 per thousand, and total deaths from 129 per thousand to 111 per thousand.
Due to the high incidence, disability rate, and mortality of hypertension, coupled with low awareness, medication, and control rates, if not actively prevented and treated, the incidence and mortality of cardiovascular and cerebrovascular diseases closely related to hypertension could rise sharply. Understanding the pathophysiological characteristics of hypertension and providing targeted prevention and treatment for different types of hypertension can significantly reduce healthcare costs, alleviate the burden on individuals, families, and society, align with China's national conditions, and play a major role in improving the health level of the Chinese people. In recent years, there have been rapid advancements in the pathogenesis and clinical treatment of hypertension both domestically and internationally. This book not only focuses on introducing practical knowledge of hypertension for clinical use but also attempts to systematically present the latest developments and trends both domestically and internationally, such as large-scale clinical trials and new progress. It is designed to be (illustrated and easy to understand), organically combining theoretical foundations with clinical practice to suit the reading needs of medical professionals and cardiovascular specialists.