Arq. Bras. Cardiol. 2019; 113(4): 696-698
Social Determinants of Hypertension
DOI: 10.5935/abc.20190220
This Short Editorial is referred by the Research article "Prevalence of Systemic Arterial Hypertension and Associated Factors Among Adults from the Semi-Arid Region of Pernambuco, Brazil".
Hypertension (HT) is a disease with high prevalence in adults and is generally referred to as a ‘complex disease’. This term has been used to indicate the diversity of factors that contribute to its onset.,
Studies in populations, twins, and families estimate that the impact of genetic background on the onset of HT ranges from 34% to 64%. However, pressure regulation depends on a multiplicity of organs, systems, and mechanisms, which is why a large number of genes affect individual values. As a result, genetic tests are still largely ineffective as predictors of HT, since monogenic inheritance of this disease is rare. Non-genetic factors are also numerous and are linked to lifestyle (nutrition, physical activity, alcohol and tobacco consumption, among others) or to the presence of conditions connected with a chronic inflammatory state, such as obesity and insulin resistance. In the presence of these factors, blood pressure increase with age is faster, leading to, at a given moment, blood pressure levels indicative of the presence of the disease. It is important to point out that the cutoffs that separate the states of ‘normotension’ and ‘hypertension’ are statistical, being suitable for use with populations, and potentially unsuitable in assessing individuals, as the disease may be present in a subclinical state, i.e., even before reaching diagnostic blood pressure levels obtained in epidemiological studies. Therefore, given the difficulty of using genetic data, disease prevention should be undertaken by identifying risk factors that contribute to raising blood pressure. In this context, epidemiological knowledge about specific populations is an essential tool for handling the disease.
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