Group 2496.png

How can hypertension be diagnosed?

A blood pressure reading measures the pressure in the arteries when the heartbeats (top number, called systolic pressure) and between heartbeats (bottom number, called diastolic pressure).1

 

Frame 23436.png

 

Measure BP three times (1–2 min apart) and average the last 2 readings.2

What is the classification of office blood pressure and the definition of hypertension grades?

Group 2491.png

Adapted from Ref.3

 

The BP category is defined by the highest level of BP, whether systolic or diastolic.
a Isolated systolic or diastolic hypertension is graded 1, 2 or 3 according to SBP and DBP values in the ranges indicated. The same classification is used for adolescents ≥16 years old.

 

What are the complications of hypertension?

 

Persistently elevated blood pressure and hypertension lead to hypertension-mediated organ damage and cardiovascular disease.2

 

Group 2609.png

Double the Risk: Exploring the Relationship Between Hypertension and Diabetes

 

Hypertension is a well-known complication of diabetes mellitus and diabetes is a well-known complication of hypertension4


 

Prevalence of hypertension in Diabetic patients

 

Group 2610.png

Shared Risk Factors

OBSITY

Frame 427318882.png

SEDENTARY LIFESTYLE

Frame 427318912.png

POOR DIET

Frame 427318880.png

FAMILY HISTORY

Frame 427318913.png

Adapted reference 6

Pathophysiology

Frame 42 (1).png

Insulin resistance

Frame 42 (2).png

Hormonal disturbance

Frame 42 (3).png

Endothelial Dysfunction

Frame 42 (4).png

Increased abdominal fats

Adapted reference 7

  • Diabetes Effects on Hypertension7
  • Worsens insulin resistance
  • Damages blood vessels, raising blood pressure

 

  • Hypertension Effects on Diabetes7
  • Increases insulin resistance
  • Accelerates kidney damage
image 1.png

Adapted reference 8

PREVENTION & MANAGEMENT

Frame 68 (1).png

Early detection

Frame 68 (2).png

Life style changes

Frame 68 (3).png

Medication adherence

Adapted reference 6

High Blood Pressure, High Risk: How Hypertension Fuels Heart Failure

 

Hypertensive heart disease can happen if you have unmanaged high blood pressure for a long time. The added strain on your heart could lead to heart failure or other health problems9

Prevalence of hypertension with heart failure

Group 2611.png

Diagnostic Work-up

Frame 468 (1).png

 

Blood Pressure Monitoring: Chronic hypertension is diagnosed with regular blood pressure readings

 

Frame 468 (2).png

 

Echocardiogram: To assess heart function, including the presence of LVH, diastolic dysfunction, or systolic dysfunction

 

Frame 468 (3).png

 

BNP/Pro-BNP Levels: Elevated levels suggest heart failure and can guide diagnosis

Adapted reference 10

Pathophysiology

image 2.png

Adapted reference 10

 

In the most widely accepted model of hypertensive heart failure, chronic pressure overload leads to the development of left ventricular hypertrophy (LVH). Progressive hypertrophy and fibrotic changes in the heart lead to progressive diastolic dysfunction ultimately leading to elevated left sided filling pressures and diastolic heart failure. Eventually, a subset of patients progresses to systolic dysfunction in the presence of chronic volume and pressure overload.12

PREVENTION & MANAGEMENT

Frame 68 (1).png

 

Lifestyle Modifications: Weight loss, reduced sodium intake, and increased physical activity to manage both hypertension and heart failure.

Frame 68 (3).png

 

Medication adherence

Adapted reference 9

Understanding the Hypertension–Chronic Kidney Disease Axis

 

CKD and high blood pressure are closely tied together. Either condition can lead to or worsen the other13

 

Group 2601.png
Group 2600.png

Adapted from Ref.14

Schematic representation of factors involved in kidney damage, hypertension and end-stage renal disease (ESRD). Figure shows complications arise upon activation of the renin-angiotensin system (RAS) secondary to kidney damage. Increased RAS activity subsequently activates angiotensin-
1 receptor (AT1 receptors) via increasing angiotensin II (Ang II) and decreases glomerular filtration rate (GFR). Angiotensin 1 receptor activation results in amyriad of effects such as vascular remodeling and inflammation, aldosterone release, sodium/H2Oretention, disturbs the balance between antioxidant (superoxide dismutase; SOD) and oxidant (nicotine amide dinucleotide phosphate; NADPH) mechanisms14

PREVENTION & MANAGEMENT

 

The good news is that there is a lot to do to prevent or manage both CKD and high blood pressure13

 

Frame 427318939.png

Adapted from Ref.13

Hypertension and Myocardial Infarction: Understanding the Connection

 

Systemic hypertension is the most prevalent cardiovascular risk factor resulting in premature death15

 

Rectangle.png

Prevalence of hypertension is reportedly 30%‐40% among patients with an ST‐elevation myocardial infarction (STEMI) and rises up to 70% in patients with a non–ST‐elevation myocardial infarction (NSTEMI).16

Pathophysiological factors that link hypertension with acute coronary syndromes.16

Rectangle 36.png

ACE, angiotensin‐converting enzyme; ACS, acute coronary syndrome; Ang II, angiotensin II; BKB2, bradykinin B2; KCNMA1, Ca++‐dependent potassium channel alpha1 subunit; LVH, left ventricular hypertrophy; NO, nitric oxide

 

By adopting a heart-healthy lifestyle, patient can17:

 

BP: Blood pressure; SBP: Systolic blood pressure; DBP: Diastolic blood pressure.

References

  1. High blood pressure (hypertension) - Diagnosis & treatment - Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417; Last accessed: 11/05/2025. Understanding Blood Pressure Readings _ American Heart Association. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings; Last accessed: 11/05/20252.

  2. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, Christodorescu RM, Daskalopoulou SS, Ferro CJ, Gerdts E, Hanssen H. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024 Aug 30;45(38):3912-4018. Available at: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension; Last accessed: 13/05/2025.

  3. Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan ML, Tsioufis K, Agabiti-Rosei E, Algharably EA, Azizi M, Benetos A, Borghi C. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). Journal of Hypertension. 2023 Dec;41(12):1874-2071. Available at: https://journals.lww.com/jhypertension/fulltext/2023/12000/2023_esh_guidelines_for_the_management_of_arterial.2.aspx; Last accessed: 13/05/2025.

  4. Ohishi M. Hypertension with diabetes mellitus: physiology and pathology. Hypertension research. 2018 Jun;41(6):389-93.

  5. Venugopal K, Mohammed MZ. Prevalence of hypertension in type-2 diabetes mellitus. CHRISMED Journal of Health and Research. 2014 Oct 1;1(4):223-7.

  6. Wang W, Wan Q, Wang S, Ning G, Bi Y, Liu L, Liu Y, Liu Y, Li X, Li T, Wu X. Management Guidelines for Diabetic Patients With Hypertension. Journal of Diabetes. 2025 Jun;17(6):e70093.

  7. Hezam AA, Shaghdar HB, Chen L. The connection between hypertension and diabetes and their role in heart and kidney disease development. Journal of Research in Medical Sciences. 2024 Apr 1;29(1):22.

  8. Petrie JR, Guzik TJ, Touyz RM. Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Canadian Journal of Cardiology. 2018 May 1;34(5):575-84

  9. clevelandclinic.hypertensive heart diseases available at: https://my.clevelandclinic.org/health/diseases/21840-hypertensive-heart-disease last accessed:15/12/2025

  10. European Society of Cardiology. Hypertension and heart failure, a dangerous relationship. Available at: https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/hypertension-and-heart-failure-a-dangerous-relationship# last accessed:15/12/2025

  11. Gallo G, Savoia C. Hypertension and heart failure: From pathophysiology to treatment. International Journal of Molecular Sciences. 2024 Jun 17;25(12):6661.

  12. Slivnick J, Lampert BC. Hypertension and heart failure. Heart failure clinics. 2019 Oct 1;15(4):531-41.

  13. Chronic Kidney Disease(CDC) . Chronic Kidney Disease and High Blood Pressure available at: https://www.cdc.gov/kidney-disease/risk-factors/chronic-kidney-disease-ckd-and-adults-with-high-blood-pressure.html? last accessed:16/12/2025

  14. Ameer OZ. Hypertension in chronic kidney disease: What lies behind the scene. Frontiers in pharmacology. 2022 Oct 11;13:949260

  15. Talle MA, Ngarande E, Doubell AF, Herbst PG. Prevalence of myocardial injury and myocardial infarction in patients with a hypertensive emergency: a systematic review. Diagnostics. 2022 Dec 26;13(1):60.

  16. Konstantinou K, Tsioufis C, Koumelli A, Mantzouranis M, Kasiakogias A, Doumas M, Tousoulis D. Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective. The Journal of Clinical Hypertension. 2019 Aug;21(8):1135-43

  17. American Heart Association. How to Manage High Blood Pressure available at: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure .last accessed:16/12/2025

Notified to Egyptian Drug Authority: ONA4998-04032026. Invalidation date: 04/03/2027.
Kindly report any violated online promotional, educational and awareness material not having this message to The General administration for Regulation of Marketing & Advertising Materials at: www.edaegypt.gov.eg

ONA4998_qrCode 1.png

ONA4998-01032026
04/03/2027

Adverse Events Reporting

We encourage using the following Electronic reporting tool for reporting into the safety database directly:
If the electronic reporting tool is not working - please use the following: https://www.report.novartis.com
1 - Generic Mailbox: [email protected]
2 - CISCO: +20 2 2 2861000: Press 3 for Adverse Events Reporting