Multiple Cardiovascular Risk Factors Indicate Cardiovascular Disease in Stage 1 Hypertension.

In November 2017, the American College of Cardiology and American Heart Association released new guidelines on hypertension that lowered the blood pressure (BP) definition of stage 1. Impedance cardiography (ICG) has shown that ventricular, vascular, and hemodynamic abnormalities are prevalent in adults over 40 years of age with at least 2 cardiovascular (CV) risk factors. This suggests that all stage 1 hypertension patients with multiple CV risk factors, over 40 years of age, have earlystage CV disease and should be treated. For many of these patients, ICG testing has shown low cardiac index with high systemic vascular resistance or vice versa. If only BP is measured, these significant extremes in hemodynamics would be unknown. With ICG data, drug selection and titration can be customized based on the abnormal underlying mechanisms to rapidly control BP while reducing adverse side effects and preventing progression of CV disease.