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A state-of-the-art review of research findings that contribute to an understanding of hypertension and the best measures for its prevention and control, whether in individual patients or entire populations. Noting that elevated blood pressure is a massive health problem in almost every country, the report argues that programs for hypertension control should be an integral part of all national health care systems. With this goal in mind, the report aims to help policy makers appreciate the significance and complexities of hypertension, understand the options available for control and then select the most appropriate mix of interventions. Details range from recommended procedures for obtaining...
Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled. A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several rec...
The fourth report from the Nat. High Blood Pressure Educ. Program (NHBPEP) Working Group on Children & Adolescents. This report updates clinicians on the latest recommendations concerning the diagnosis, evaluation, & treatment of hypertension in children; recommendations are based on English-language, peer-reviewed, scientific evidence (from 1997 to 2004) & the consensus expert opinion of the NHBPEP Working Group. This report includes new data from the 1999-2000 Nat. Health & Nutrition Exam. Survey, as well as revised blood pressure tables that include the 50th, 90th, 95th, & 99th percentiles by sex, age, & height. Charts & tables.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for ...
Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chroni...
This report presents the recommendations of the WHO Expert Committee responsible for updating the WHO Model List of Essential Medicines. The first part contains a progress report on the new procedures for updating the Model List and the development of the WHO Essential Medicines Library. It continues with a section on changes made in revising the Model List followed by a review of some sections such as hypertensive medicines and fast track procedures for deleting items. Annexes include the 13th version of the Model List and items on the list sorted according to their 5-level Anatomical Therapeutic Chemical classification codes.
For over 30 years, the stepped care approach has been used in the management and treatment of hypertension. This approach advocates the use of initial monotherapy to reach the desired blood pressure, and the subsequent use of additional drugs with complementary modes of action, until the target BP is achieved. However, current control rates for hypertension suggest that such an approach may be outdated and no longer effective in the management of hypertension. Clinical trials have shown that more than 50% of patients require a combination of drug therapies to achieve their target BP. Some proponents of combination therapy have argued that the risk of adverse side effects and non-compliance w...
The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
Good management is central to any strategy formulated to control hypertension at the community level. These guidelines are aimed at standardizing the management and care of hypertension, including control of blood pressure and complications in people with established hypertension and identification of individuals with high blood pressure who are at increased risk of complications; and at promoting integration of prevention of hypertension into primary health care settings, including lifestyle measures for prevention and management and cost-effectiveness. The guidelines are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as health and policy-makers. They provide the necessary information for decision-making by health care providers or patients themselves about disease management in the most commonly encountered situations.