High blood pressure and cardiovascular disease
Open accessAbstract
Fragmented investigation has masked the overall picture for causes of cardiovascular disease (CVD). Among the risk factors for CVD, high blood pressure (BP) is associated with the strongest evidence for causation and it has a high prevalence of exposure. Biologically, normal levels of BP are considerably lower than what has typically been characterized as normal in research and clinical practice. We propose that CVD is primarily caused by a right-sided shift in the population distribution of BP. Our view that BP is the predominant risk factor for CVD is based on conceptual postulates that have been tested in observational investigations and clinical trials. Large cohort studies have demonstrated that high BP is an important risk factor for heart failure, atrial fibrillation, chronic kidney disease, heart valve diseases, aortic syndromes, and dementia, in addition to coronary heart disease and stroke. In multivariate modeling, the presumed attributable risk of high BP for stroke and coronary heart disease has increased steadily with progressive use of lower values for normal BP. Meta-analysis of BP-lowering randomized controlled trials has demonstrated a benefit which is almost identical to that predicted from BP risk relationships in cohort studies. Prevention of age-related increases in BP would, in large part, reduce the vascular consequences usually attributed to aging, and together with intensive treatment of established hypertension would eliminate a large proportion of the population burden of BP-related CVD.
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High blood pressure is the single leading risk factor for cardiovascular disease worldwide.
“High blood pressure (BP) is the single leading risk factor for cardiovascular disease worldwide,1–4”
From International Consensus on Standardized Clinic Blood Pressure Measurement – A Call to Action (2023) · cites this paper as [2]
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“High blood pressure (BP) is a primary cause of cardiovascular diseases [1].”
BackgroundSelf-citationZare, M. G., Okati-Aliabad, H., Ansari-Moghaddam, A., Mohammadi, M., & Shahraki-Sanavi, F. (2023) · PLOS ONE · doi:10.1371/journal.pone.0295270 · Cited by 11 · see citing works
- Authors
- Fuchs, F. D., & Whelton, P. K.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Tulane University (US)
- Corresponding author
- Whelton, Paul K.
- Venue
- Hypertension
- Published
- 2020-02
- Volume
- 75
- Issue
- 2
- Pages
- 285-292
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC10243231
- OpenAlex
- W2998223455
- Cited by
- 1,948
- References
- 65
- Citations by year
- 2026: 253 · 2025: 449 · 2024: 483 · 2023: 372 · 2022: 256 · 2021: 110 · 2020: 25
- FWCI
- 17.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (P20GM109036)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- hypertension, cardiovascular disease, cardiovascular risk factors, stroke, coronary artery disease, heart failure, atrial fibrillation, chronic kidney disease, valvular heart disease, aortic syndrome, dementia, age-related blood pressure increase, cardiovascular disease prevention
- MeSH terms
- Aging, Cardiovascular Diseases, Humans, Hypertension, Preventive Health Services, Public Health, Risk Factors, Causality
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