Definition

Hypertension is systolic pressure ≥140 mm Hg or diastolic pressure ≥90 mm Hg for the general population, and ≥130 or ≥80 mm Hg for certain groups including patients with diabetes and chronic kidney disease. 1

There are two broad categories of hypertension - primary (or essential) and secondary hypertension.

Approximately 90-95% of patients diagnosed with hypertension have primary hypertension.

 

Unlike secondary hypertension, there is no known cause of primary hypertension.

Therefore, the diagnosis of primary hypertension is made after excluding known causes that comprise what is called secondary hypertension.

 

  • Hypertension is blood pressure of 130/80 mm Hg or higher in adults 

 

Arterial hypertension is the condition of persistent elevation of systemic blood pressure (BP). BP is the product of cardiac output and total peripheral vascular resistance.

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According to the JNC-7 report, blood pressure is classified as normal, prehypertension, stage 1 hypertension, and stage 2 hypertension.

This classification is important as it guides therapy including lifestyle modifications and the choice of medications, and correlates well with the risk of cardiovascular complications.

Starting at 115/75 mm Hg, for every 20/10 mm Hg of systolic/diastolic blood pressure elevation, the risk of cardiovascular disease doubles.

Patients with prehypertension should be counseled on lifestyle modifications to prevent progression to hypertension.

Patients with stage 1 and 2 hypertension should be counseled on lifestyle modifications and started on pharmacologic treatment.

In patients with systolic pressures ≥20 mm Hg or diastolic pressures ≥10 mm Hg above goal, initial treatment with 2 medications should be strongly considered.

 

 

 

Hypertension, Primary

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