ABSTRACT
Table 7.1 lists the numerous cardiometabolic risk factors. This chapter will review the risk of cardiovascular complications and outcomes associated with each of these cardiometabolic risk factors.
Hypertension continues to be one of the most prevalent and treatable components of the cardiometabolic syndrome. A recent review of the National Health and Nutrition Examination Survey (NHANES) suggests that an estimated 58.4 million Americans have high blood pressure requiring therapy1. Worldwide, the prevalence of hypertension has been estimated to be as high as 1 billion people with 7.1 million deaths per year related to its complications2. In the US, hypertension continues to be underdiagnosed and undertreated with approximately 30% of patients remaining unaware of their hypertension, 40% of patients not receiving any treatment, and another two-thirds with blood pressure above 140/903. The prevalence of hypertension increases with age with approximately 75% of patients aged 70 or older demonstrating high blood pressure4. The recent Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Despite major advances in prevention and management, cardiovascular disease continues to be the leading cause of death in the United States. Although significant efforts have been made to reduce the burden of cardiovascular risk, the prevalence of risk factors continues to be high within the US population. As our understanding of the pathophysiology of cardiovascular disease grows, new risk factors such as the metabolic syndrome and markers of inflammation including C-reactive protein (CRP) are being recognized. These newly defined risk factors identify additional patients at increased risk of cardiovascular events that may not have been previously recognized. Furthermore, the majority of patients now present with multiple risk factors that may have a synergistic effect on overall cardiovascular risk. The term
(JNC VII) proposed new definitions for hypertension and prehypertension (Table 7.2)3.
