How can we get the most common, costly, and modifiable cardiovascular risk factor under control?
Cardiovascular disease (CVD) is the number one cause of death with an upward trend beyond 30% and a tripling in costs between 2010 and 2030, which places a significant economic burden on public healthcare services worldwide1,2,3. The most common risk factor for developing CVD is hypertension1 affecting one billion individuals worldwide4. While hypertension is the most “modifiable”1 risk factor, the challenge posed to the specialists around the world is that it very often remains undetected and symptom-free at an early stage and is only treated when it has already become a long-term disease.
So it is critical for cardiologists around the world to understand the influencing factors for hypertension in order predict or detect early and hopefully prevent this widespread disease.
In a brand new study publication with the Task Force® Monitor (TFM)in the Journal Nature, Man et al. investigated the essential cardiovascular parameters of five large consanguineous families to find out if hypertension is heritable and if it depends on genetic and/or environmental factors. The study team found “moderate heritability for blood pressure”5 and concluded that environmental factors were more significant.
Other TFM studies have also proven that physical activity has a positive impact on the cardiovascular system4,6,7. Considering that “physical inactivity is now the fourth leading cause of death worldwide”8, the correlation seems obvious. O’Driscoll et al. showed that the kind of exercise can influence efficacy as isometric exercise training has a higher positive impact on resting arterial pressure than traditional aerobic and resistance training4. Exercise training therefore not only supports the therapy for hypertension patients but also plays an important role as efficient preventive measure.6
Specialists have developed quite a number of various risk prediction approaches to identify individuals who are at high risk of developing hypertension “for timely prevention and treatment at an early stage before obvious symptoms happen.”3, as reported by Lin et al. With powerful monitoring tools which are already available on the market, an early detection of cardiovascular risk factors has become possible.
There is evidence that long-term complications of undetected, untreated or ineffectively controlled hypertension can also lead to cerebrovascular diseases, an impairment of the cognitive function and even organ damage. Czuriga‐Kovács et al. showed that early detection and promptly initiated antihypertensive management carried out over a period of one year in 72 patients, resulted in an effective decrease of blood pressure accompanied not only “by a more balanced hemodynamic state”9, but also by reversed cognitive changes.9
We can conclude from these findings that efficient risk prediction is important for an early detection and timely treatment with preventive measures, which might reverse the implications of hypertension or even avoid its onset. With this knowledge we can contribute to a better cardiovascular health by making the “most common, costly, and preventable CVD risk factor”2 an avoidable one. This might finally lead to the efficient reduction of the terrifying number of hypertensive patients and the high cost for health organizations.
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(1) Taylor, K. A., Wiles, J. D., Coleman, D. A., Leeson, P., Sharma, R., & O’Driscoll, J. M. (2019). Neurohumoral and ambulatory haemodynamic adaptations following isometric exercise training in unmedicated hypertensive patients. Journal of Hypertension, 37(4), 827–836. http://doi.org/10.1097/hjh.0000000000001922
(2) Pescatello, L. S., Buchner, D. M., Jakicic, J. M., Powell, K. E., Kraus, W. E., Bloodgood, B., … Piercy, K. L. (2019). Physical Activity to Prevent and Treat Hypertension. Medicine & Science in Sports & Exercise, 51(6), 1314–1323. http://doi.org/10.1249/MSS.0000000000001943
(3) Lin, W.-H., Zhang, H., & Zhang, Y.-T. (2013). Investigation on Cardiovascular Risk Prediction Using Physiological Parameters. Computational and Mathematical Methods in Medicine, 2013, 1–21. http://doi.org/10.1155/2013/272691
(4) O’Driscoll, J. M., Taylor, K. A., Wiles, J. D., Coleman, D. A., & Sharma, R. (2017). Acute cardiac functional and mechanical responses to isometric exercise in prehypertensive males. Physiological Reports, 5(7). Retrieved from http://physreports.physiology.org/content/5/7/e13236
(5) Man, T., Riese, H., Jaju, D., Muñoz, M. L., Hassan, M. O., Al-Yahyaee, S., … Snieder, H. (2019). Heritability and genetic and environmental correlations of heart rate variability and baroreceptor reflex sensitivity with ambulatory and beat-to-beat blood pressure. Nature Scientific Reports, 9(1), 1–8. http://doi.org/10.1038/s41598-018-38324-6
(6) Taylor KA, Wiles JD, Coleman DD, Sharma R, O’Driscoll JM. Continuous Cardiac Autonomic and Haemodynamic Responses to Isometric Exercise. Med Sci Sport Exerc [Internet]. 2017 Mar 27 [cited 2017 May 26];1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28350715
(7) O’Driscoll JM (2018). Cardiac autonomic and left ventricular mechanics following high intensity interval training: A randomised cross-over controlled study. J Appl Physiol [Internet]. 2018 Jun 28 [cited 2018 Sep 10];japplphysiol.00056.2018. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29952247
(8) Fiuza-Luces, C., Santos-Lozano, A., Joyner, M., Carrera-Bastos, P., Picazo, O., Zugaza, J. L., … Lucia, A. (2018). Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nature Reviews Cardiology, 15(12), 731–743. http://doi.org/10.1038/s41569-018-0065-1
(9) Czuriga‐Kovács, K. R., Szekeres, C. C., Bajkó, Z., Csapó, K., Oláh, L., Magyar, M. T., … Csiba, L. (2019). Hypertension‐induced subclinical vascular and cognitive changes are reversible—An observational cohort study. The Journal of Clinical Hypertension, 21(5), 658–667. http://doi.org/10.1111/jch.13537