hypertension_127Hypertension is defined as systolic blood pressure (SBP) of 140 mmHg or greater, diastolic blood pressure (DBP) of 90 mmHg or greater, or taking antihypertensive medication.
VI JNC, 1997
Types of hypertension
Essential hypertension
90%
No underlying cause
Secondary hypertension
Underlying cause
Causes of Secondary Hypertension
Renal
Parenchymal
Vascular
Others
Endocrine
Neurogenic
Miscellaneous
Unknown
Hypertension: Predisposing factors
Age > 60 years
Sex (men and postmenopausal women)
Family history of cardiovascular disease
Smoking
High cholesterol diet
Co-existing disorders such as diabetes, obesity and hyperlipidaemia
High intake of alcohol
Sedentary life style
1999 WHO-ISH Guidelines : Definitions and Classifications of BP Levels
SBP DBP
Category* (mm Hg) (mm Hg)
Optimal < 120 < 80
Normal < 130 < 85
High-normal 130-139 85-89
Grade 1 hypertension (mild) 140-159 90-99
Borderline subgroup 140-149 90-94
Grade 2 hypertension (moderate) 160-179 100-109
Grade 3 hypertension (severe) > 180 > 110
ISH > 140 < 90
Borderline subgroup 140-149 < 90
WHO-ISH Guidelines mittee J Hypertens 1999; 17:151
Diseases Attributable to Hypertension
HYPERTENSION
Gangrene of the Lower Extremities
Heart Failure
Left Ventricular Hypertrophy
Myocardial Infarction
Hypertensive Encephalopathy
Aortic Aneurym
Blindness
Chronic Kidney Failure
Stroke
Preeclampsia/Eclampsia
Cerebral Hemorrhage
Coronary Heart Disease
Adapted from Dustan HP et al. Arch Intern Med. 1996; 156: 1926-1935
1999 WHO-ISH Guidelines: Desirable BP Treatment Goals
Optimal or normal BP (< 130/85 mm Hg) for
Young patients
Middle-age patients
Diabetic patients
High-normal BP (< 140/90 mm Hg) desirable for elderly patients
Aggressive BP lowering may be necessary in patients with nephropathy, chronic renal failure, particularly if proteinuria is
< 1 g/d - 130/80 mm Hg
> 1 g/d - 125/75 mm Hg
Significant benefits from intensive BP reduction in diabetic patients
Major CV events / 100 patient-yr
Lancet 199
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