Hypertension: An Overview


  • Naufal Rivo Aditya Students
  • Syazili Mustofa Bagian Fisiologi, Biomolekular, Biokimia, Fakultas Kedokteran, Universitas Lampung


Anti-hypertensive agents, chronic disease, hypertension, risk factor


Chronic disease is a worldwide health issue. The prevalence of chronic disease is 6,7 billion people worldwide, and has increased over the time. Chronic disease is a noncommunicable disease, but chronic disease is a persistant disease and resulting in substansial years of life lost. One of the chronic diseases is hypertension or high blood pressure. The prevalence of hypertension is 1,2 billion people worldwide and increasing due to an aging population and increasing prevalence of obesity. Hypertension is multifactorial disease involving genetic factors and environmental factors. Aparts from these two factors, behaviors factors can be increasing risk factor for hypertension, such as smooking and excess salt consumption. AHA (American Heart Association) hypertension guidelines, hypertension is diagnosed when blood pressure is consistently >130 for systolic pressure, and or >80 mmHg for diastolic pressure. Hypertension have a significant effects due to CVD (Cardiovascular disease) such as hearth failure, myocardial infarction, stroke and death. Hypertension in older adults have a adverse effects and exacerbated by a decrease in body function and quality, such as mechanical hemodynamic changes, arterial stiffness, neurohormonal and declining renal function, so the management strategies for hypertension in older adults must consider from various aspects, such as comorbidities factors, pyscho-social factors. The management strategies for hypertension can be used non-pharmacological therapy to reduce the risk of hypertension severity and provide appropriate pharmacological therapy according to the patient’s condition, so that it can provide appropriate results.


Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Journal of Comprehensive Physiology. 2012;2(2):1143-1211.

Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abera SF, Aboyans V, Dkk. Global, regional and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the global burden of disease study 2016. Journal of Lancet. 2017;390:1151-210.

Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Journal of Preventing Chronic Disease. 2014;11:1-4.

Bruins MJ, Dael PV, Eggersdorfer M. The role of nutrients in reducing the risk for noncommunicable diseases during aging. Journal of Nutrients. 2019;11(1):1-24.

Rossier BC, Bochud M, Devuyst O. The hypertension pandemic: an evolutionary perspective. Journal of Physiology. 2017;32:112-25.

Beaglehole R, Bonita R, Hortno R, Adams C, Alleyne G, Asaria P, Dkk. Priority actions for the non-communicable disease crisis. Journal of Lancet. 2011;377(9775):1438-47.

Mara T, Wang S, Wang L, Yang F, Wen Cao G, Teng Ma L, Dkk. The prevalence rates of major chronic diseases in retired and in service Chinese military officers (2000-2016): a meta-analysis. Journal of Military Medical Research. 2018;5(4):1-11.

Chapel JM, Ritchey MD, Zhang D, Wang G. Prevalence and medical costs of chronic diseases among adult Medicaid beneficiaries. American Journal of Preventive Medicine. 2017;53(6 Suppl 2):S143-54.

Padmanabhan S, Caulfield M, Dominiczak AF. Genetic and molecular aspects of hypertension. Journal of Circulation Research. 2015;116(6):937-59.

Oliveros E, Patel H, Kyung S, Fugar S, Goldberg A, Madan N, Dkk. Hypertension in older adults: assessment, management and challenges. Journal of Clinical Cardiology. 2020;43(2):99-107.

Feign VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Dkk. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Journal of Lancet Nurology. 2016;15(9):913-24.

Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, Dkk. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Journal of Lancet. 2016;387(10022):957-67.

Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Dkk. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Journal of Circulation. 2019;140:e596-646.

GBD 2017 Risk Factor Collaborators. Global, regional and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Journal of Lancet. 2018;392:1923-94.

Iqbal AM, Jamal SF. Essential hypertension [internet]. Treasure Island; 2021 [diperbarui tanggal 20 Juli 2020; disitasi tanggal 17 Maret 2021]. Tersedia dari: https://www.ncbi.nlm.nih.gov/books/NBK539859/#_NBK539859_pubdet_.

Ewald DR, Haldeman LA. Risk factors in adolescent hypertension. Journal of Global Pediatric Health. 2016;3:1-26.

Le-Ha C, Beilin LJ, Burrows S, Huang RC, Oddy WH, Hands B, Dkk. Oral contraceptive use in girls and alcohol consumption in boys are associated with increased blood pressure in late adolescene. European Journal Preventive Cardiology. 2013;20(6):947-55.

Sundar JS, Adaikalam JM, Prameswari S, Valarmarthi S, Kalpana S, Shantharam D, Dkk. Prevalence and determinants of hypertension among urban school children in the age group of 13 – 17 years in Chennai, Tamilnadu. Journal of Epidemiology. 2013;3(3):1-5.

Giontella A, Bonafini S, Tagetti A, Bresadola I, Minuz P, Gaudino R, Dkk. Relation between dietary habits, physical activity and anthropometric and vascular parameters in children attending the primary school in the Verona South district. Journal of Nutrients. 2019;11(5):1-16.

Casas R, Castro BS, Estruch R, Sacanella E. Nutrition and cardiovascular health. International Journal of Molecular Science. 2018;19(12):1-31.

World Health Organization. Commission on ending childhood obesity: report of the commission on ending childhood obesity. Switzerland: World Health Organization; 2016.

Kelly RK, Magnussen CG, Sabin MA, Cheung M, Juonola M. Development of hypertension in overweight adolescent: a review. Journal of Adolescent Health Medicine Therapy. 2015;6:171-87.

Rosner B, Cook NR, Daniels S, Falkner B. Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988-2008. Journal of Hypertension. 2013;62(2):247-54.

Kotchen TA. Obesity-related hypertension: epidemiology, pathophysiology and clinical management. American Journal Hypertension. 2010;23(11):1170-8.

Shihab HM, Meoni LA, Chy AY, Wang NY, Ford DE, Laing KY, Dkk. Body mass index and risk of incident hypertension over the life course: the Johns Hopkins Precursors Study. Journal of Circulation. 2012;126(25):2983-9.

Solanki JD, Mehta HB, Shah CJ. Pulse wave analyzed cardiovascular parameters in young first degree relatives of hypertensives. Journal of Research Medical Science. 2018;23:1-15.

Ji X, Qi H, Li DB, Liu RK, Zheng Y, Chen HL, Dkk. Associations between human aldosterone synthase CYP11B2 (-344T/C) gene polymorphism and antihypertensive response to valsartan in Chinese patients with essential hypertension. International Journal Clinical Experimental Medicine. 2015;8(1):1173-77.

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, Dkk. 2018 ESC/ESH guidelines for the management of arterial hypertension. European Heart Journal. 2018;39:3021-104.

Lionakis N, Mendrions D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World Journal Cardiology. 2012;4(5):135-47.

Buford TW. Hypertension and aging. Journal Ageing Research Reviews. 2016;26:96-111.

Lacolley P, Regnault V, Segers P, Laurent S. Vascular smooth muscle cells and arterial stiffening: relevance in development, aging and disease. Journal Physiology Reviews. 2017;97(4):1555-617.

Gorini S, Kim SK, Infante M, Mammi C, Vignera SL, Fabbri A, Dkk. Role of aldosterone and mineralocorticoid receptor in cardiovascular aging. Journal Frontiers in Endocrinology. 2019;10(584):1-41.

Grassi G, Mark A, Esler M. The sympathetic nervous system alterations in human hypertension. Journal Circulation Research. 2015;116(6):976-90.

Ferra N, Komici K, Corbi G, Pagano G, Furgi G, Rengo C, Dkk. -adrenergic receptor responsiveness in aging heart and clinical implications. Journal Frontiers in Physiology. 2014;4:1-10.

Brignole M, Moya A, Lange FJ, Fanciulli A, Fedorowski A, Furlan R, Dkk. 2018 ESC guidelines for the diagnosis and management of syncope. European Heart Journal. 2018;39(21):1883-948.

Ricci F, De Caterina R, Fedorowski A. Orthostatic hypotension: epidemiology, prognosis and treatment. Journal American College of Cardiology. 2015;66(7):848-60.

Rucker AJ, Rudemiller NP, Crowley SD. Salt, hypertension and immunity. Journal Annual Review of Physiology. 2018;80:283-307.

Pavlov TS, Staruschenko A. Involvement of ENaC in the development of salt sensitive hypertension. American Journal Physiology Renal Physiology. 2017;313(2):135-140.

Kemenkes RI. Pedoman teknis penemuan dan tatalaksana hipertensi. Jakarta: Kementrian Kesehatan RI; 2013.

World Health Organization. A global brief on hypertension: silent killer, global public health crisis. Switzerland: World Health Organization; 2013.

Vlachopoulus C, Xaplenteris P, Aboyans V, Brodmann M, Cifkova R, Cosentino F, Dkk. The role of vascular biomarkers for primary and secondary prevention. Journal of Atherosclerosis. 2015;241:507-32.

Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, Dkk. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. Journal of Hypertension. 2012;30:445-48.

Clase CM, Barzilay J, Gao P, Smyth A, Schmieder RE, Tobe S, Dkk. Acute change in glomerular filtration rate with inhibition of the renin-angiotensi system does not predict subsequent renal and cardiovascular outcomes. Journal of Kidney International. 2019;91:683-90.

Liu L, Quang ND, Banu R, Kumar H, Tham YC, Cheng CY, Dkk. Hypertension, blood pressure control and diabetic retinopathy in a large population-based study. PLos One. 2020;15(3):1-23.

Muiesan ML, Salvetti M, Di Castelnuovo A, Paini A, Assanelli D, Costanzo S, Dkk. Obesity and ECG left ventricular hypertrophy. Journal of Hypertension. 2017;35:162-9.

Ladecola C, Yaffe K, Biller J, Bratzke LC, Faraci FM, Gorelick PB, Dkk. Impact of hypertension on cognitive function: a scientific statement from the American Heart Association. Journal of Hypertension. 2016;68(6):67-94.

James PA, Oparil S, Handler J, Lackland DT, MacKenzie TD, Teler SJ, Dkk. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the eighth joint national committee 8 (JNC 8). Journal American Medical Association. 2013;18:1-14.

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A,Bohm M, Dkk. 2013 ESH/ESC guidelines for the management of arterial hypertension. European Heart Journal. 2013;34:2159-219.

Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL. Dkk. European guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal. 2016;37:2315-81.

Suckling RJ, He FJ, Markandu ND, Macgregor GA. Modest salt reduction lowers blood pressure and albumin excretion in impaired glucose tolerance and type 2 diabetes mellitus: a randomized double-blind trial. Journal of Hypertension. 2016;67:1189-95.

Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low-sodium diet vs high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. American Journal Hypertension. 2012;25:1-15.

Hall JE, Do Carmo JM, Da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohormonal and renal mechanism. Journal Circulation Research. 2015;116:991-1006.

Jordan J, Yumuk V, Schalaich M, Nilsson PM, Zahorska-Markiewicz B, Grassi G, Dkk. Obesity and difficult to treat arterial hypertension. Journal Hypertension. 2012;30:1047-55.

Kotseva K, Wood D, De Bacquer D, De Backer G, Rayden L, Jennings C, Dkk. European society of cardiology survery on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. European Journal Prevention Cardiology. 2016;23:636-48.

Holmes MV, Dale CE, Zuccolo L, Silverwood RJ, Guo Y, Ye Z, Dkk. Association between alcohol and cardiovascular disease: Mendelian randomization analysis based on individual participant data. British Medical Journal. 2014;349:1-46.

Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. Journal American Heart Association. 2013;2(1):1-19.

Rossi A, Dikareva A, Bacon SL, Daskalopouluo SS. The impact of physical activity on mortality in patients with high blood pressure: a systematic review. Journal Hypertension. 2012;30:1277-88.

Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment in hypertension: discontinuations for adverse events attributed to different classes of antihypertensive drugs. Journal Hypertension. 2016;34:1921-32.

Fried LF, Emanuele N, Zhang JH, Brophy M, Conner TA, Duckworth W, Dkk. Combined angiotensin inhibition for the treatment of diabetic nephropathy. New England Journal of Medicine. 2013;369:1892-903.

Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome inciden: effects in individuals with high-normal and normal blood pressure. Journal Hypertension. 2017;35:2150-60.

Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering on outcome incidence in hypertension: head-to-head comparisons of various classes of antihypertensive drugs-overview and meta analyses. Journal Hypertension. 2015;33:1321-41.

Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering on outcome incidence in hypertension: effects of various classes of antihypertensive drugs-overview and meta-analyses. Journal Hypertension. 2015;33:195-211.

Olde ER, Frenkel WJ, Van De Bogaard B, Brewster M, Vogt L, Van Den Born BJ. Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: systematic review and meta-analysis. Journal Hypertension. 2015;65:1033-40.

Edmin CA, Rahimi K, Neal B, Callender T, Perkovic V, Patel A. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. Journal American Medical Association. 2015;313:603-15.

Dondo TB, Hall M, West RM, Jernberg T, Lindahl B, Bueno H, Dkk. Beta-blockers and mortality after acute myocardial infarction in patients without heart failure or ventricular dysfunction. Journal American College Cardiology. 2017;69:2710-20.

Ayers K, Byrne LM, DeMatteo A, Brown NJ. Differential effects of nebivolol and metoprolol on insulin sensitivity and plasminogen activator inhibitor in the metabolic syndrome. Journal Hypertension. 2012;59:893-98.