Abstract: . . .  lighter-weight people Approximate SBP reduction (range),mm Hg 520 per 10 kg lost 814 28 49 24 * Body mass index 18.524.9 kg/m 2 . DASH=Dietary Approaches to Stop Hypertension .The effects of implementing these modifications are dose- and time- dependent and could be more dramatic for some individuals. SOURCE:JNC-7 2003 Page 18 16 P&T DIGEST JNC-7 GUIDELINES diuretic/beta blocker combination, renin levels remain essentially at baseline. Aldosterone levels may also rise with a diuretic but are re- duced with a beta blocker. When the two agents are used together,al- dosterone levels remain essentially unchanged. The rise in renin or aldosterone may not negate the BP-lowering ef- fects of the diuretic, but adding an agent that neutralizes the effects of activation of the RAAS, . . .
. . .  significant. CHF=coronary heart failure;LVH=left ventricular hypertrophy;CVD=cerebrovascular disease;CHD=coronary heart disease. SOURCE:HEBERT 1993,MOSER 1996 16 21 35 38 52 Diastolic BP Systolic BP Page 19 the benefit or if specific medica- tions affect outcomes. In 1999, a World Health Orga- nization committee reviewed the available data on the treatment of hypertension and concluded that reducing BP, as opposed to the choice of medication, accounted for most of the benefit (WHO 1999). The committee recom- mended diuretics, beta blockers, ACE inhibitors, CCBs, or alpha blockers as initial therapy. But is there is at least some difference in outcome with different medica- tions? Most available medications diuretics, beta blockers, ACE inhibitors,ARBs,and CCBs re- duce BP with appropriate . . .
. . .  than 823 million office visits in 2000,essential hypertension accounted for more than 1 of every 25 (Table 2). TABLE 2 Office visits,2000 Number Share of visits of visits Primary diagnosis (millions) (%) Hypertension 35.1 4.3 Routine well-child visit 33.9 4.1 Acute upper-respiratory infections 30.7 3.7 Diabetes mellitus 23.6 2.9 Arthritis/related disorders 23.2 2.8 Pregnancy 22.4 2.7 Cancer 21.8 2.6 General medical examination 18.3 2.2 Rheumatism (excluding back) 16.5 2.0 Ear infections 16.3 2.0 SOURCE:CHERRY 2002 Economic impact of hypertension In terms of direct and indirect costs, hypertension carries a $50.3 billion annual price tag in the United States (Figure 9). FIGURE 9 Estimated cost of hypertension * 2003 estimates . . .
--3000,3,500,3253,64496