|
In this lecture I intend to discuss the role of blood
pressure as a risk factor, recognising the different components of the blood pressure
measurement – diastolic, systolic and pulse pressure. I will define what I consider as
the high risk phenotype, and point out that there is a paradox around the nature of
hypertension in obesity. I will also describe the paradox of salt sensitivity and renin
level as cardiovascular risk factors and attempt to resolve these by looking at recent
data. The question of treatment will be discussed at some length, and particularly why it
might be that treatment of blood pressure, with virtually any agent, is able almost
completely to reverse the adverse effects of pressure on coronary heart disease and stroke
risk within two to three years. Finally, I will tackle the question of where diabetes fits
in, in terms of both risk and treatment. |