OVERVIEW
Hypertension, commonly referred to as high or elevated blood pressure is a leading cause of death and disability in the US and worldwide. Hypertension per se increases a person’s risk of developing coronary artery disease, stroke, heart failure and other serious conditions. More than 60% of people 65 years of age or older have high blood pressure, and the number of individuals with high blood pressure is increasing throughout all age groups. In addition, hypertension is almost invariably present in patients with kidney disease and in a number of neurological and metabolic disorders. Based on data from the American Heart Association, the prevalence of hypertension among US adults 20 years of age or older was 32.6% for the period 2009-2012, which represents ~80 million US adults, and it is estimated that more than 972 million adults worldwide are hypertensive. Projection studies predict that by 2030, and in the US only, approximately 42% of adults will have hypertension, an estimated increase of 8.4%.
In Ohio, data provided by the Ohio Department of Health indicates that nearly one third of adults have high blood pressure, and during the period 1997-2005 the prevalence of hypertension increased by 23%. Remarkably, in Ohio only more than 14,000 children and adolescents 3 to 18 years of age have hypertension, of which 74% were undiagnosed.
In general, high blood pressure can be controlled through lifestyle modification and medication. Yet, an important number of patients manifest what is known as resistant hypertension, i.e., blood pressure that remains above goal in spite of the concurrent use of 3-4 antihypertensive drugs. Whereas the exact prevalence of resistant hypertension is unknown, data from the National Health and Nutrition Examination Survey of the Centers for Disease Control and Prevention indicates that among hypertensive US adults approximately 9% (~24 million adults) meet the criteria for resistant hypertension. In addition, the prevalence of hypertension and its response to pharmacological intervention are deeply influenced by sex, age, race, ethnicity and individual genetic traits. The Systolic Blood Pressure Intervention Trial (SPRINT), a research study funded by the National Institutes of Health (NIH), enrolled more than 9,000 participants throughout over 90 clinics across the US and Puerto Rico to answer the question whether lowering the recommended goal for systolic blood pressure (<140 mm Hg) might help to reduce heart disease, stroke, progression of chronic kidney disease, and age-related memory and/or thinking disturbances. The beneficial results obtained by setting the goal of systolic blood pressure at <120 mm Hg was so significant (30% reduction in combined cardiovascular events and 27% reduction in all-cause mortality) that the NIH stopped the study earlier (~3 years after initiated) to begin the review process that will eventually lead to an update of the national blood pressure guidelines for clinicians to follow as the national standard for hypertension prevention and treatment.
In order to foster interdisciplinary research, training, education and public awareness on hypertension, in 2012 the Board of Trustees of the University of Toledo approved the creation of the Center for Hypertension and Precision Medicine (CHPM). Dr. Bina Joe is its founding Director. Initially focused on understanding the genetics of high blood pressure, Dr. Joe developed a strong and unique program on Physiological Genomics of Hypertension. With the vision of expanding the Center's research scope, Dr. Joe set the ground for the development of a vascular physiology program. The Vascular Physiology program, now led by Dr. Guillermo Vazquez, takes into consideration several aspects of hypertension-related vascular disease, such as the roles of the immune system, metabolism, epigenetics and microbiota. Standing on the platforms of Physiological Genomics and Vascular Physiology, the CHPM has rapidly grown into a multidisciplinary team of basic and clinical scientists with expertise in genetics, proteomics, metabolomics, vascular biology, cardiac and renal physiology, metabolism, neurophysiology.
Today, the CHPM is the only comprehensive hypertension research center in northwest Ohio that integrates such a diversity of themes from both basic and clinical perspectives with the common goal of finding alternative preventative and therapeutic strategies for this devastating disease.