Predicting and preventing hypertension and associated cardiovascular disease.

THE DEVELOPMENT OF HYPERTENSION CAN BE PREDICTED BY SUCH FACTORS AS: age, salt, alcohol and fiber intake, obesity, physical activity, psychosocial factors, and family history of hypertension or premature cardiovascular disease. Blood pressure response to stressful stimuli is also an important predictor. Research should focus on better assessment and management of predictors including psychosocial factors which increase blood pressure, and personality characteristics that increase sensitivity to stressful stimuli. Since inheritance of blood pressure may be considerable, detecting a hypertensive patient should stimulate the family physician to measure blood pressure of other family members. Future management of hypertension may involve increased public health activity to improve detection, education and management in the community while more efficient office management integrates the patient into the decision making process.