Hypertension

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Contents

More Specific Terms

Introduction

Classification 


*                               systolic      diastolic 
* normal                           < 120          < 80 
* prehypertension [12,13]         120-139         80-89 
* hypertension     
*  stage I   (mild)              140-159         90-99 
*  stage II  (moderate)          160-179        100-109 
*  stage III (severe)            180-209        110-119 
*  stage IV  (very severe)         > 210         > 120



Etiology

  • primary (essential) hypertension
  • pharmacologic causes:

Epidemiology

  • 10-20% of persons age 25-45 years
  • 30-40% of persons age 55-74 years
  • 60% of persons > 65 years of age

Pathology

Genetics

  • monogenic forms of hypertension

History

Clinical-manifestations

  • acute changes
  • acute changes
  • chronic changes
  • vascular manifestations
  • acute changes
  • chronic changes
  • renal changes
  • acute changes
  • chronic changes

Diagnostic-criteria

Laboratory

Diagnostic-procedures

Radiology

Complications

Management

  • acute treatment of hypertension
  • oral agents
  • Every 2 months for blood pressure 140-160/90-100
  • Every 2 weeks for blood pressure 160-180/100-110
  • Every week for blood pressure > 180/110
  • hospitalize for blood pressure > 210/120
  • Also consider:

More General Terms

Additional Terms

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39, 340-346
  2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 220-221
  3. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 65-84
  4. Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
  5. Prescriber's Letter 7(12):79-70 2000
  6. Journal Watch 21(3):21, 2001 Mogensen et al Randomised controlled trial of dual blockade of renin- angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. BMJ 321:1440, 2000 PMID: [1]
  7. Journal Watch 22(8):61, 2002 Oliveria SA et al Physician-related barriers to the effective management of uncontrolled hypertension. Arch Intern Med 162:413, 2002 PMID: [2]
  8. Journal Watch 22(8):61, 2002 Boutitie F et al J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med 136:438, 2002 PMID: [3]
  9. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  10. Prescriber's Letter 10(1):1 2003
  11. Prescriber's Letter 10(4):19 2003
  12. Journal Watch 24(1):5, 2004 Chobanian AV et al The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560, 2003 PMID: [4]
  13. Chobanian AV et al Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 42:1206, 2003 PMID: [5]
  14. Cappuccio FP et al, Gender-specific associations of short sleep duration with prevalent and incident hypertension: The Whitehall II Study. Hypertension 2007, 50:693 PMID: [6]
  15. US Preventive Services Task Force. Screening for high blood pressure: US Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2007, 147:783 PMID: [7]
    - Wolff T and Miller T Evidence for the US Preventive Services Task Force recommendation on screening for high blood pressure. Ann Intern Med 2007, 147:787 PMID: [8]
  16. Knutson KL et al Association Between Sleep and Blood Pressure in Midlife The CARDIA Sleep Study Arch Intern Med. 2009;169(11):1055-1061 PMID: [9]
  17. O'Connor GT et al Prospective study of sleep-disordered breathing and hypertension: The Sleep Heart Health Study. Am J Respir Crit Care Med 2009, 179:1159 PMID: [10]
  18. Powers BJ et al Measuring Blood Pressure for Decision Making and Quality Reporting: Where and How Many Measures? Annals of Internal Medicine: June 20, 2011 154(12):781-788 <PubMed> PMID: [11] <Internet> [12]
    - Appel LJ et al Improving the Measurement of Blood Pressure: Is It Time for Regulated Standards? Annals of Internal Medicine: June 20, 2011 154(12):838-39 <PubMed> PMID: [13] <Internet> [14]
  19. High Blood Pressure: NIH Institute and Center Resources [15]
  20. National Guideline Clearinghouse 2007 guidelines for the management of arterial hypertension. European Society of Cardiology ngc-guideline: [16]
    - Hypertension diagnosis and treatment. (Institute for Clinical Systems Improvement) ngc-guideline: [17]
    - Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement. ngc-guideline: [18]
    - VHA/DoD clinical practice guideline for the diagnosis and management of hypertension in the primary care setting. ngc-guideline: [19]
    - American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of hypertension. (American Association of Clinical Endocrinologists) ngc-guideline: [20]
    - Routine chest radiographs in uncomplicated hypertension. (American College of Radiology) ngc-guideline: [21]
    - Guide to management of hypertension 2008. Assessing and managing raised blood pressure in adults. National Heart Foundation of Australia ngc-guideline: [22]
    - Hypertension - detection, diagnosis and management. Medical Services Commission, British Columbia ngc-guideline: [23]
    - Essential hypertension. University of Michigan Health System. ngc-guideline: [24]
    - Clinical practice guidelines on arterial hypertension. 2007 update. Basque Health System - Osakidetza ngc-guideline: [25]

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