EDITORIAL-Blood Pressure as a Risk Factor of Global Disease Burden and its Associationwith Lifetime Risks of Different Manifestations of CardiovascularDisease

摘要

The evaluation of lifetime cardiovascular disease (CVD) risk and the life-years lost due to CVD in specific agegroups in a population of 1.25 million people showed that not all elements of hypertension are causally associated with allmanifestations of CVD. High systolic blood pressure (BP) was strongly related to intracerebral haemorrhage, subarachnoidhaemorrhage, stable angina, myocardial infarction, and peripheral arterial disease (PAD). On the other hand, highdiastolic BP had a stronger relationship with abdominal aortic aneurysm and pulse pressure had a stronger associationwith PAD and an inverse association with abdominal aortic aneurysm. Unstable angina was related to loss of life inyounger ages, whereas heart failure and stable angina pectoris were related to years of life lost in the elderly. Thus, specificelements of BP were linked to specific manifestations of CVD and causes of death by CVD. Another recent studyanalysed the independent effects of 67 all-disease risk factors in 21 regions worldwide in 2010 and compared them withthose of 1990. Hypertension immerged as the first cause of all-cause disease burden (7%), while in 1990 it was not includedin the first 3 causes. A shift from communicable diseases of the children to the non-communicable diseases of theadults was also recorded in this 20-year period. A plethora of data suggests the hypertension is the number one killer bothin Western World and Worldwide. The adoption of lifetime CVD risk estimates combined with efforts for increasedawareness, education, and BP control will probably improve outcomes and substantially reduce CVD mortality.