7^th World Congress on Hypertension and Public Health September 26-27, 2019 Holiday Inn Lisbon-Continental, Portugal

\r\n Pulmonary hypertension (PH) is high blood pressure in the arteries to the lungs where the blood vessels that carry blood from the heart to the lungs become hard and narrow, this causes difficulty in pumping the blood, which ultimately weakens the heart leading to the condition of heart failure. However, recent advances in drug therapy have created major impact in the developments of symptom management and survival. The PH symptoms are dizziness, chest pain, swelling in the ankles, legs and abdomen, bluish colour in lips and skin, racing pulse or heart palpitations. PH may be the result of diseases in the pulmonary arteries, left heart failure, lung disease, pulmonary embolism.

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\r\n High blood pressure in children and adolescents is one of the most common problems that the children are facing. They may contribute to premature atherosclerosis and the early development of cardiovascular diseases. Pediatric hypertension can be either primary or secondary and they are categorized as prehypertension (between 90th to 95th percentile), stage 1 (95th to 99th percentile plus 5 mmHg) and stage 2 (≥ 99th percentile plus 5 mmHg) hypertension. People who are between 3 to 18 years of age, the prevalence of prehypertension and hypertension was found to be 3.4 % and 3.6 % respectively.  Normally a blood pressure values varies by age, sex, and height. Therefore, awareness has to be taken seriously for the diagnosis and treatment of hypertension.

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\r\n Gestational hypertension or pregnancy-induced hypertension (PIH) is the development of high blood pressure greater than 140/90 mm Hg in a pregnant woman. It occurs after 20 weeks of gestation and leads to a serious condition called preeclampsia, also referred to as toxemia. Due to this condition, it may prevent the placenta from receiving enough blood, which can cause low birth weight in the baby.

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\r\n The symptoms of gestational hypertension includes rapid weight gain, high blood pressure, protein in the urine, and swelling in the hands, feet, and face, severe headaches, a change in reflexes, reduced output of urine or no urine, abdominal pain, blood in the urine, dizziness, or excessive vomiting and nausea, spots before the eyes.

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Resistant hypertension is defined as uncontrolled blood pressure elevating to approximately (>140/90 mm Hg) after treatment with three or more antihypertensive drugs, such patients are more likely to have a secondary cause and has a high risk of end-organ damage. ACE inhibitor (or an angiotensin receptor blocker), a diuretic and a calcium channel blocker preclude resistant hypertension, which must be ruled out before a diagnosis can be made.

The prognosis of resistant hypertension is not known, however cardiovascular risk is beyond any doubt raised as patients usually have a history of long-standing, severe hypertension sophisticated by multiple different cardiovascular risk factors such as obesity, sleep apnea, diabetes, and chronic renal disorder. The diagnosing of resistant hypertension needs use of excellent blood pressure technique to verify persistently elevated blood pressure levels. Pseudo resistance, including lack of blood pressure management secondary to poor medication adherence or white coat hypertension, should be excluded.

\r\n Sexual dysfunction is difficulty experienced by an individual during any stage of sexual activity, including physical pleasure, desire, arousal or orgasm. The common risk factors associated with sexual dysfunction for men and women including individual general health status, cardiovascular disease, other genitourinary disease, psychiatric/psychological disorders, diabetes mellitus, other chronic disease, and socio-demographic conditions.

\r\n During the treatment of hypertension, antihypertensive drugs such as diuretics, potassium sparring diuretics and β-blockers are used, which results in erectile dysfunction. Sexual dysfunction disorders may be classified into four types: orgasm disorders, sexual desire disorders, arousal disorders and pain disorders.

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\r\n Hypertension is an extremely common comorbid condition in diabetes which significantly reduces the risk of macrovascular and microvascular complications, including stroke, coronary artery disease, and peripheral vascular disease, retinopathy, nephropathy, and possibly neuropathy.  It majorly depends on obesity, age and ethnicity. The use of angiotensin-converting enzyme inhibitors may slow progression to kidney failure and cardiovascular mortality, but these agents are the preferred therapy for managing diabetes and hypertension.

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Resistant hypertension is defined as uncontrolled blood pressure elevating to approximately (>140/90 mm Hg) after treatment with three or more antihypertensive drugs, such patients are more likely to have a secondary cause and has a high risk of end-organ damage. ACE inhibitor (or an angiotensin receptor blocker), a diuretic and a calcium channel blocker preclude resistant hypertension, which must be ruled out before a diagnosis can be made.

The prognosis of resistant hypertension is not known, however cardiovascular risk is beyond any doubt raised as patients usually have a history of long-standing, severe hypertension sophisticated by multiple different cardiovascular risk factors such as obesity, sleep apnea, diabetes, and chronic renal disorder. The diagnosing of resistant hypertension needs use of excellent blood pressure technique to verify persistently elevated blood pressure levels. Pseudo resistance, including lack of blood pressure management secondary to poor medication adherence or white coat hypertension, should be excluded.

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\r\n Hypertensive heart disease refers to heart problems occurring due to elevated blood pressure that is present over an extended period of time. Without treatment of high blood pressure, symptoms of heart failure can develop. It may lead to the thickening of the muscles which ultimately results in the deficient of the oxygen, this may cause angina (chest pain). High blood pressure also ends up in thickening of the blood vessel walls. When combined with cholesterol deposits within the blood vessels, the chance of heart attack and stroke will increase. Hypertensive heart disease is that the leading cause of unwellness and death from high blood pressure.

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\r\n Hypertension is the single most important risk factor for stroke, doubling the risk of stroke for each 20 mm Hg increase in systolic blood pressure (SBP). Although reducing the blood pressure can lower stroke risk by 30% to 40%

\r\n In comparison with other antihypertensive agents, angiotensin receptor blockers (ARB) provide additional protection against stroke and other cardiovascular diseases.

\r\n The strain hypertension weakens the blood vessels and predisposes them to damage, results in the blockage. This causes an ischemic stroke and hypertension is the most important cause of this type of stroke and also transient ischemic attacks.

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\r\n Obesity increases the risk of the development of hypertension. Obesity-associated arterial hypertension is characterized by stimulation of the sympathetic nervous system, reaction of the renin-angiotensin system, and sodium retention, among other abnormalities.

\r\n Obesity is characterized with increased blood flow, vasodilatation, cardiac output, and hypertension. Although cardiac index does not increase, cardiac output and glomerular filtration rate do. However, renal sodium retention also increases, leading to the cause of hypertension.

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\r\n The risk factors of hypertension are age, smoking, diet, alcohol, cholesterol level, diabetes, ethnicity, family history, obesity, sedentary lifestyle, medication, recreation drugs. Regular physical activity decreases the risk of cardiovascular disease including high blood pressure, diabetes, breast and colon cancer, and depression. The prevention of hypertension is possible based on correct lifestyle and nutrition, starting from childhood age. The mediation that are used to treat high blood pressure are Thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, alpha blockers, alpha-beta blockers, beta blockers, aldosterone antagonists, renin inhibitors,  vasodilators, central-acting agents.

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\r\n Overall, approximately 20% of the world’s adults are estimated to have high blood pressure. The prevalence dramatically elevates in patients older than 60 years: In many countries, 50% of individuals in this age group have hypertension. Worldwide, approximately 1 billion people have hypertension, contributing to more than 7.1 million deaths per year.

\r\n National health surveys in various countries have shown a high prevalence of poor control of hypertension. [6] These studies have reported that prevalence of hypertension is 22% in Canada, of which 16% is controlled; it is 26.3% in Egypt, of which 8% is controlled; and it is 13.6% in China, of which 3% is controlled.

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\r\n Cardiology is a branch of medicine dealing with disorders of the heart and also the parts of the circulatory system. The field includes medical diagnosis and treatment of coronary artery disease, heart failure, congenital heart defects, valvular heart disease and electrophysiology. The symptoms that indicates a heart problem includes, shortness of breath, changes in heart rate or rhythm, high blood pressure, dizziness, chest pains.

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\r\n Cardiovascular disease (CVD) is a condition affecting the heart or blood vessels, where it is mainly associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots. The main four types of CVD are coronary heart disease, strokes (Transient ischaemic attack), peripheral arterial disease and aortic disease. The main causes of CVD are high blood pressure, smoking, high cholesterol, diabetes, obesity.

\r\n There are many risk factors for heart diseases: age, gender, raised blood pressure (hypertension), excessive alcohol consumption, tobacco use, physical inactivity, unhealthy diet, obesity, raised blood sugar (diabetes mellitus), raised blood cholesterol (hyperlipidemia).

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