Hypertension is the most common preventable cause of premature all-cause mortality, primarily from cardiovascular disease (CVD). Individuals with dysglycemia, including prediabetes and diabetes, are at increased risk. Licorice intake raises blood pressure (BP) through the effects of glycyrrhizic acid (GA), but the true limit of safe intake is uncertain. Home BP has several benefits over BP measured at a clinic, including a higher predictive value for CVD. By combining office and home BP, it is possible to diagnose masked hypertension (MH), in which home but not office BP is elevated, and white coat hypertension (WCH), in which office but not home BP is elevated. The aim of this thesis was to advance our knowledge on home BP in relation to dysglycemia, markers of CVD, and licorice intake. The first 3 papers used data from the Linköping cohort of the prospective Swedish CArdioPulmonary bioImage Study (SCAPIS). Study IV was a randomized controlled cross-over study. Data was obtained from questionnaires, blood samples and office and home BP measurements. In studies I-III, pulse wave velocity (PWV), coronary artery calcium score (CACS), and carotid artery plaques as markers of CVD were also included. In Study I, we examined 5025 men and women aged 50-64 years old for the relation between dysglycemia and home BP. Both the systolic office and home BP measurements were positively as-sociated with dysglycemia. Participants with dysglycemia vs normoglycemia more often had MH. The findings were in line with previous research and strengthened the association between dysglycemia and MH. In Study II, we examined the associations between MH and markers of CVD in 4122 individuals without BP-lowering treatment. Of participants, 4.2% had MH, and these were more often men and had higher BMI than those with normotension. Participants with MH also had higher odds for CACS ≥100, an as-sociation which has previously been suggested as a trend. In Study III, we examined the relation between soluble P-se-lectin (sP-selectin) as a measure of thrombotic activity, plasma high-sensitivity C-reactive protein (hsCRP) as a measure of inflammation, and home BP in 4548 participants. Both markers were higher in each hypertension phenotype compared with sustained normotension. The quartile of participants with the highest sP-se-lectin values had higher odds for CACS ≥100 and carotid artery plaques. The association between sP-selectin and sustained hyper-tension was novel and not affected by adjustments for hsCRP. In Study IV, 28 healthy participants aged 18-30 years old were evaluated for the effects of a daily intake of licorice containing 100 mg of GA compared with a control product for 2 weeks. During the licorice intake period, the systolic home BP increased with 3.1 mmHg, and the suppression of serum aldosterone and plasma renin levels indicated that this was due to the licorice intake. In conclusion, this thesis further strengthens the idea that both home and office BP measurements have values beyond that of the other, and that home BP may be most valuable in individuals with dysglycemia and obesity, and in men. Finally, licorice may be more potent than previously known, suggesting the need for increased awareness. Förhöjt blodtryck (hypertoni) är den huvudsakliga orsaken till förtida död, främst genom hjärtkärlsjukdom. Flera mekanismer och riskfaktorer som kan förklara hypertoni har identifierats. Individer med förhöjt blodsocker, inklusive diabetes och dess förstadier, lö-per ökad risk för hjärtkärlsjukdom, och förhöjt blodsocker samexisterar ofta med hypertoni. Lakritsintag höjer blodtrycket genom dess beståndsdel glycyrrhizinsyra (GA), och även om både Europeiska unionen och Världshälsoorganisationen har föreslagit att ett intag av upp till 100 mg per dag sannolikt är säkert att förtära för de flesta individer, är den gränsnivån osäker. Jämfört med blodtryck som mäts på mottagningen av medicinskt utbildad personal har hemblodtryck flera fördelar, inklusive starkare koppling till framtida hjärtkärlsjukdom. Genom att kombinera mottagnings- och hemblodtryck går det att diagnosticera maskerad hypertoni (MH), då hemblodtrycket är förhöjt trots normalt mottagningsblodtryck, och vitrockhypertoni (WCH), då mottagningsblodtrycket men inte hemblodtrycket är förhöjd. Syftet med denna avhandling var att vidare utforska hemblodtryck i relation till förhöjt blodsocker, markörer för hjärtkärlsjukdom, och lakritsintag. Avhandlingens fyra arbeten baseras på två studier. I de första tre arbetena analyserades data från Linköpings-kohorten i the Swedish CArdioPulmonary bioImage Study (SCAPIS), en prospektiv studie av män och kvinnor i åldrarna 50-64 år. I det sista arbetet analyserades data från en lottad överkorsningsstudie. Data i studierna bestod av enkätsvar, blodprover, samt mottagnings- och hemblodtrycksmätningar. I studie I-III ingick även pulsvågshastighet, kalkhalt i kranskärlen vid skiktröntgen (CACS) och plack-förekomst i halspulsådrorna vid ultraljudsundersökning som markörer på hjärtkärlsjukdom. I det första delarbetet undersökte vi data för 5025 individer avseende blodtryck och förhöjt blodsocker. Både mottagnings- och hemblodtryck var associerat med förhöjt blodsocker. Deltagare med förhöjt blodsocker hade oftare MH jämfört med de med normalt blodsocker, och skillnaden mellan mottagnings- och hemblodtrycket var omvänt associerat med långtidsblodsocker. Fynden var i linje med tidigare forskning, och stärkte kända kopplingar mellan MH och förhöjt blodsocker. Förklaringarna till detta samband är okända, men möjliga sådana inkluderar selektiva effekter av blodtryckssänkande läkemedel hos individer med förhöjt blodsocker, samsjukligheter såsom fetma, och aktivering av det sympatiska nervsystemet. I det andra delarbetet analyserade vi förekomst av och associationer för MH hos 4122 individer utan pågående blodtryckssänkande läkemedelsbehandling. Av dessa hade 4.2% MH, och dessa var oftare män och hade högre BMI än de med normalt blodtryck. Deltagare med MH hade också högre pulsvågshastighet och oftare förhöjt CACS. Associationen mellan MH och markörer för hjärt-kärlsjukdom var tidigare känd och styrktes av våra resultat. I det tredje delarbetet undersökte vi 4548 deltagare avseende två blodprovsmarkörer: en för blodplättsaktivitet, lösligt P-selektin i blodet, och en för inflammation, högkänsligt C-reaktivt protein (hsCRP). Både P-selektin och hsCRP var högre vid hypertoni, oavsett typ, jämfört med vid normalt blodtryck. Den kvartil av deltagarna som hade högst P-selektin hade oftare WCH och hypertoni både hemma och på mottagningen, jämfört med normalt blodtryck, och oftare förhöjt CACS och plack i halspulsådrorna. Associationen mellan P-selektin och högt blodtryck både hemma och på mottagningen var inte tidigare känd, och påverkades inte av justering för hsCRP, vilket antydde att den inte enbart förklarades av inflammation. I det fjärde och sista delarbetet inkluderas 28 friska individer i åldrarna 18 till 30 år. I en överkorsningsstudie bad vi deltagarna att dagligen under 2 veckor inta antingen lakrits med ett innehåll av 100 mg GA eller en kontrollprodukt utan lakrits. Deltagarna undersöktes med avseende på hemblodtryck, liksom hormonnivåer i blodet. Under lakrits- jämfört med kontrollperioden steg det systoliska hemblodtrycket med 3,1 mmHg, och hormonnivåerna påverkades på ett sätt som talade för att GA påverkade blodtrycket. Sammanfattningsvis stärker studiernas resultat kunskapen om att blodtrycksmätning både på mottagningen och i hemmet är värdefullt både var för sig och tillsammans, och att hemblodtryck är särskilt värdefullt hos individer med förhöjt blodsocker eller övervikt, samt hos män. Slutligen visade sig små mängder lakrits påverka kroppen mer än tidigare känt, och ökad medvetenhet och bättre etikettering av lakritsprodukter kan vara befogad.

Hypertension remains a leading cause of disability and death worldwide. Self-monitoring of blood pressure by patients at home is currently recommended as a valuable tool for the diagnosis and management of hypertension. Unfortunately, in clinical practice, home blood pressure monitoring is often inadequately implemented, mostly due to the use of inaccurate devices and inappropriate methodologies. Thus, the potential of the method to improve the management of hypertension and cardiovascular disease prevention has not yet been exhausted. This volume presents the available evidence on home blood pressure monitoring, discusses its strengths and limitations, and presents strategies for its optimal implementation in clinical practice. Written by distinguished international experts, it offers a complete source of information and guide for practitioners and researchers dealing with the management of hypertension.

How to play a vital role in your own health and longevity: A handbook from“one of the most reliable, respected health resources that Americans have” (Publishers Weekly). This easy-to-use guide will help you understand the many issues related to high blood pressure and assist you in preventing it, managing it, and making essential treatment decisions. · Learn which single factor you can do the most about when it comes to influencing your blood pressure. This one step may be all it takes to lower your blood pressure and keep it under control. · How losing as little as 10 pounds may reduce your blood pressure to a healthier level—includes practical help for maintaining a healthier weight. · Discover a great alternative that may lower your blood pressure just about as much as medications—without the expense of prescriptions. · Why your blood pressure goes down if you make your heart stronger—and dozens of tips to realize this goal. · How to manage your sodium intake. · Information about medications for when changes in lifestyle aren't enough and more

Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled. A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several recommendations that embody a population-based approach grounded in the principles of measurement, system change, and accountability. The recommendations are designed to shift current hypertension reduction strategies from an individual-based approach to a population-based approach. They are also designed to improve the quality of care provided to individuals with hypertension and to strengthen the Center for Disease Control and Prevention's leadership in seeking a reduction in the sodium intake in the American diet to meet dietary guidelines. The book is an important resource for federal public health officials and organizations, especially the Center for Disease Control and Prevention, as well as medical professionals and community health workers.

A shocking one in three American adults has high blood pressure, yet barely half of them have it under control. Millions more have high blood pressure and don't even know it because there are no warning signs or symptoms. It's called the silent killer because the first "symptom" is often a stroke or heart attack. Fortunately, high blood pressure is easy to detect and treat. Sometimes people can keep blood pressure in a healthy range simply by making lifestyle changes, such as losing weight, increasing activity, and eating more healthfully. In this Special Health Report from Harvard Medical School experts, you'll uncover the best ways to stop this silent killer, including: 5 ways to lower your chances of ever getting high blood pressure.

This book by the National Institutes of Health (Publication 06-4082) and the National Heart, Lung, and Blood Institute provides information and effective ways to work with your diet because what you choose to eat affects your chances of developing high blood pressure, or hypertension (the medical term). Recent studies show that blood pressure can be lowered by following the Dietary Approaches to Stop Hypertension (DASH) eating plan-and by eating less salt, also called sodium. While each step alone lowers blood pressure, the combination of the eating plan and a reduced sodium intake gives the biggest benefit and may help prevent the development of high blood pressure. This book, based on the DASH research findings, tells how to follow the DASH eating plan and reduce the amount of sodium you consume. It offers tips on how to start and stay on the eating plan, as well as a week of menus and some recipes. The menus and recipes are given for two levels of daily sodium consumption-2,300 and 1,500 milligrams per day. Twenty-three hundred milligrams is the highest level considered acceptable by the National High Blood Pressure Education Program. It is also the highest amount recommended for healthy Americans by the 2005 "U.S. Dietary Guidelines for Americans." The 1,500 milligram level can lower blood pressure further and more recently is the amount recommended by the Institute of Medicine as an adequate intake level and one that most people should try to achieve. The lower your salt intake is, the lower your blood pressure. Studies have found that the DASH menus containing 2,300 milligrams of sodium can lower blood pressure and that an even lower level of sodium, 1,500 milligrams, can further reduce blood pressure. All the menus are lower in sodium than what adults in the United States currently eat-about 4,200 milligrams per day in men and 3,300 milligrams per day in women. Those with high blood pressure and prehypertension may benefit especially from following the DASH eating plan and reducing their sodium intake.

Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.

The fourth report from the Nat. High Blood Pressure Educ. Program (NHBPEP) Working Group on Children & Adolescents. This report updates clinicians on the latest recommendations concerning the diagnosis, evaluation, & treatment of hypertension in children; recommendations are based on English-language, peer-reviewed, scientific evidence (from 1997 to 2004) & the consensus expert opinion of the NHBPEP Working Group. This report includes new data from the 1999-2000 Nat. Health & Nutrition Exam. Survey, as well as revised blood pressure tables that include the 50th, 90th, 95th, & 99th percentiles by sex, age, & height. Charts & tables.

For the nearly 78 million Americans with hypertension, a safe, effective lifestyle plan—incorporating the DASH diet principles and much more—for lowering blood pressure naturally If you have high blood pressure, you're not alone: nearly a third of adult Americans have been diagnosed with hypertension, and another quarter are well on their way. Yet a whopping 56 percent of diagnosed patients do not have it under control. The good news? Hypertension is easily treatable (and preventable), and you can take action today to bring your blood pressure down in just four weeks—without the potential dangers and side effects of prescription medications. In Blood Pressure Down, Janet Bond Brill distills what she's learned over decades of helping her patients lower their blood pressure into a ten-step lifestyle plan that's manageable for anyone. You'll: • harness the power of blood pressure power foods like bananas, spinach, and yogurt • start a simple regimen of exercise and stress reduction • stay on track with checklists, meal plans, and more than fifty simple recipes Easy, effective, safe—and delicious—Blood Pressure Down is the encouraging resource that empowers you, or your loved ones, to lower your blood pressure and live a longer, heart-healthy life.

Here is today's most in-depth reference for any cardiologist, internist, or nephrologist interested in hypertension. Drawing from international experience in cardiology, physiology, and nephrology, Drs. Lip and Hall have assembled a group of section editors and contributors second to none. You'll find the long-term effects of primary and secondary hypertension and a lengthy section on hypertensions for special populations featured prominently. Prevention and treatment of hypertension are covered in detail, from lifestyle and diet issues to drug choice and delivery, and the section on comparison of guidelines is unique to this book. Find comprehensive coverage of hypertension including pathogenesis, prevention, and treatment all in one practical volume. See the complete systemic problems of hypertension at a glance with detailed, full-color illustrations of cellular and clinical manifestations. Simplify navigating the complexities of hypertension using algorithms for clinical exam and diagnosis. Get specific insight into prevention and treatment of hypertension in special populations. Go global with a comprehensive section on worldwide guidelines and the application of clinical material to local standards of practice.