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Towards improving the clinical assessment and management of human hypertension: an overview from this Journal

Journal of Human Hypertension volume 20, pages 913–916 (2006)Cite this article

Hypertension is a growing global problem and is responsible for considerable morbidity and mortality. Newer insights into the diagnosis and treatment have heralded a new chapter and instilled a fresh lease of life into the overall management of this ubiquitous condition. Despite this, recent studies have still shown a poor rate of detection, treatment and – more importantly – control to target blood pressure (BP) levels.1 It is possible that some of these patients have white coat hypertension and are unnecessarily treated, and improvements in our diagnostic algorithms for this condition may be needed.2 Nonetheless, our efforts may not be successful, if patients do not appreciate hypertension as a disease entity and are unaware of their BP targets, with knowledge particularly poor among female patients, the elderly, those without any college education or without a documented history of hypertension and those with known diabetes.3

Perhaps we are chasing a moving target. We no longer advise to just target ‘cutoff’ levels to treat BP – after all, hypertension is not a ‘yes/no’ phenomenon, but a graded continuous relation between stroke and coronary risk – but take a more holistic approach to cardiovascular risk assessment, and management.4 The implications of risk scoring, by changing from coronary heart disease (CHD) to cardiovascular disease (CVD) risk-based guidelines in different ethnic groups has recently been studied,5 culminating with the publication of a re-calibrated Framingham risk score to produce a web-based tool for estimating the 10-year risk of CHD and CVD in British UK black and minority ethnic groups.6 This pragmatic web-based risk calculator (ETHRISK, available at http://www.epi.bris.ac.uk/CVDethrisk/) allows 10-year risks to be estimated in routine primary care settings, for relevant risk factor and ethnic group combinations.

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  1. University Department of Medicine, City Hospital, Birmingham, UK

    P Kakar & G Y H Lip

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Correspondence to G Y H Lip.

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Kakar, P., Lip, G. Towards improving the clinical assessment and management of human hypertension: an overview from this Journal. J Hum Hypertens 20, 913–916 (2006). https://doi.org/10.1038/sj.jhh.1002083

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