The recent guidelines' recommendation for blood pressure measurement highlights the importance of office blood pressures. Starting from 115/75mmHg there is a linear correlation between blood pressure increase and the risk of death for cardiovascular and cerebrovascular diseases. The underdiagnosis of the hypertensive state induces a delay in the treatment initiation. Differences in the therapeutic approach are also evident in the different guidelines. In this chapter we will focus on the main pathophysiological mechanisms associated to the hypertensive state, in autonomic dysfunction, and the alteration in autonomic control mechanisms, and will be discussed when these mechanisms associated to the hypertensive state start to became negative, increasing and sustaining the cardiovascular risk. The beneficial effect of adrenergic tone reduction will be also considered in evaluating the therapeutic approach to the antihypertensive state.
Seravalle, G., Grassi, G. (2023). Essential hypertension. In I. Biaggioni, K. Browning, G. Fink, J. Jordan, P.A. Low, J. Paton (a cura di), Primer on the Autonomic Nervous System, Fourth Edition (pp. 467-470). Elsevier [10.1016/B978-0-323-85492-4.00096-X].
Essential hypertension
Grassi G.
2023
Abstract
The recent guidelines' recommendation for blood pressure measurement highlights the importance of office blood pressures. Starting from 115/75mmHg there is a linear correlation between blood pressure increase and the risk of death for cardiovascular and cerebrovascular diseases. The underdiagnosis of the hypertensive state induces a delay in the treatment initiation. Differences in the therapeutic approach are also evident in the different guidelines. In this chapter we will focus on the main pathophysiological mechanisms associated to the hypertensive state, in autonomic dysfunction, and the alteration in autonomic control mechanisms, and will be discussed when these mechanisms associated to the hypertensive state start to became negative, increasing and sustaining the cardiovascular risk. The beneficial effect of adrenergic tone reduction will be also considered in evaluating the therapeutic approach to the antihypertensive state.
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