Introduction Hypertension is a significant health problem due to its very high prevalence and associated risks of cardiovascular, cerebrovascular and renal complications (1) In a significant number of patients control of hypertension is difficult,in spite of effective therapy strategies (2,3). Pickering et al.(4) first determined the phenomenon of masked hypertension (MH) to describe the clinical condition of patients with elevated ambulatory blood pressure (ABP) but normal clinical blood pressure(CBP). Most of these patients were not aware of their blood pressure status and so were not receiving antihypertensive therapy (4). These MHT patients presented with target organ damages, as albuminuria and left ventricular hypertrophy. Indeed, cardiovascular disease risk is even higher in MH patients than in essential hypertensive patients.(4). MHT is a public health concern with the confluence of increased CVD risk, a failure to be diagnosed by the conventional approach of blood pressure measurement in the clinic setting, and relatively high prevalence (5,6,7,8). According to the landmark SHEAF study patients with MH are at increased risk of developing sustained hypertension (9,10). Masked hypertension (MHT) is clinically defined in non-diabetics as an office blood pressure (BP) levels lower than 140/90 mmHg and daytime BP > 135/85 using ambulatory BP monitoring (ABPM),and in those with diabetes as a OBP <130/80 mmHg and a ABPM >125/75 mmHg (11). The prevalence of MHT is accepted as 8-10% among the general population. Among the diabetic population masked hypertension prevalance is increased about two to six times in comparison to general population. In the current literature, MHT is associated with increased macrovascular and microvasc... ... middle of paper ... ...5 need intensive blood pressure regulation to prevent target organ damages. Study limitations The number of diabetic patients in this study is limited,because as a tertiary center diabetic patients referred to our institution were complex patients and most of them had overt hypertension. The second limitation of our study is;we could not make an analysis for determining factors of masked hypertension other than poor glycemic control,due to limited number of patients. Conclusion Masked hypertension incidence is increased diabetic patients especially with high HbA1c levels,even though it is not statistically different and patients of which HbA1c levels>6.5 had higher blood pressure measurements in ABPM. T2DM patients with a potentially high risk of clinical cardiovascular diseases and hypertension-induced damage to target organs should be finically evaluated for MH.
As early as the 1800s clinicians began to take a closer look at elevated blood pressure levels, they soon found high correlation between hypertension, stroke, and other heart diseases. They also established that high levels of blood pressure effected both privilege and underprivileged, and within the years they have noted the disease have become more prevalent in the African American culture. Long term studies, such as randomized controlled trial studies, unveiled
• Diabetes Mellitus: Diabetes mellitus (Type I Diabetes and Type II Diabetes) has been associated with an increase in arterial stiffness . O’Rourke’s studies showed that PWA does not aid in the diagnostics of diabetes mellitus. Further research by Cruickshank showed that PWV is a powerful independent predictor of mortality for diabetes.
Journal of Continuing Education in Nursing, 44(9), 406. doi:10.3928/00220124-20130617-38. Torpy, J. M. (2011). The 'Standard' Diabetes. Jama, 305(24), 2592 pp.
One of the main reasons hypertension can be so dangerous is because you may not even know you’re suffering from it, in fact, nearly one-third of patients suffering from hypertension don’t even know that they have it (WebMD 2015). The number one reason hypertension goes undetected for so long is because in most cases, there are no clear warning signs of the blood pressure being high. Some signs/symptoms
High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere. Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. Some people may experience: bad headache, mild dizziness, and blurry vision. Traditionally, diagnosis of high blood pressure (BP) has relied on consecutive checks of clinic BP over a 2 to 3 month period, with hypertension confirmed if BP remains persistently raised over 140/90 mmHg. This method of diagnosis has significant limitations because the BP measured for an individual patient in a clinic setting may not reflect their BP in day-to-day life. The main concern is that as a result of the “white coat syndrome”, hypertension may be over-diagnosed when checked in the clinic setting; resulting ...
Hypertension is deadly and it is a silent killer, if not detected on time, it can cause severe complications to major organs in the body.
Hypertension is considered a “silent killer” as it may not exhibit obvious signs and symptoms while it is slowly damaging the organs or causing several illnesses, such as damage to the renal arteries (renal artery stenosis), stroke, retinopathy, cardiac arrthymias, coronary artery disease and heart failure.
As many as 73 million Americans have high blood pressure. Of the 1 in every 4 adults wi...
" Journal of Clinical Hypertension 13.5 (2011): 351-56. EBSOHost.com - a. Web. The Web.
Cardiovascular disease (CVD) and chronic kidney disease (CKD) closely parallel the obesity and insulin resistance epidemic. Current U.S. estimates project 70 million obese adults and an additional 70 million with hypertension and/or type II diabetes (28, 42, 45). More so, the National Health and Nutrition Examination Survey (NHANES), suggest a graded and continuous relationship exists between prevalent hypertension and increasing body mass index (BMI); a metric that is closely associated with insulin resistance and self-identified type II diabetes (8, 34).
Hypertension affects approximately 73 million Americans. It is a chronic medical condition in which the blood pressure is elevated. Hypertension, also called high blood pressure is often seen concurrent with diabetes mellitus. Many refer to hypertension as the “silent killer” because often time’s individuals are Asymptomatic. Ideally, blood pressure is expected to be less than 120mmHg systolic and 80mmHg diastolic. Hypertension is defined as sustained blood pressure of the arteries greater than or equal to 140/90mmHg. . Twenty nine percent of Mexican American men and thirty one percent of Mexican American women are living with hypertension. Mexican American hypertension levels are compatible to non-Hispanic whites; however, they are less likely to have their blood pressure treated or controlled compared to whites and African Americans. Hypertension increases the work load of the heart leading to other chronic disease processes, most commonly myocardial infarction often referred to as a heart attack. La...
Heart failure is a condition in which the heart muscle becomes too weak to maintain an adequate cardiac output to meet the body’s oxygen demands (Wilmore, et al., 2008). Hypertension is a sustained condition when the blood pressure exceeds 140/90 mm Hg. It is estimated that about thirty percent of people ages fifty and over have hypertension. Type II diabetes is considered a milder form of diabetes and is characterized by impaired insulin secretion, impaired insulin action, or excessive glucose output from the liver (Wilmore, et al., 2008). The consequences of uncontrolled and untreated Type II diabetes, however, are the just as serious as those for Type I. This form is also called noninsulin-dependent diabetes, a term that is somewhat misleading. Many people with Type II diabetes can control the condition with diet and oral medications, however, insulin injections are sometimes necessary if treatment with diet and oral medication is not working. Gallbladder diseases from obesity mainly consist of Cholecystitis which is inflammation of the gallbladder. Osteoarthritis is a progressive disorder of the joints caused by gr...
Diabetes mellitus is a group of metabolic disorders which is characterized by hyperglycemia due to insulin deficiency or resistance or both reasons. (1) According to that diabetes mellitus can be divided as type I and type II. This is common and its incidence is rising, 171 million people had diabetes in 2000 it is expected this condition to be doubled in 2030. It is spread in all the countries and therefore has become a major burden upon healthcare facilities. (2)
WILLIAMS, P and POULTER NR et al (2004) Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society. British Hypertension Society, pp. 139-85
Schnall, P., Landsbergis, P., Belkic, K., Warren, K., Schwartz, J., & Pickering, T. (1998). Findings In The Cornell University Ambulatory Blood Pressure Worksite Study: A Review. Psychosomatic Medicine, 60, 697.