Harrison's Practice: Essential Hypertension

Essential Hypertension

Definition

Chronic elevation in blood pressure (BP) > 140/90 mmHg with no definable cause
- Represents 90–95% of hypertensive persons
- The remainder have identifiable causes (secondary hypertension).
Importance of hypertension relates to increased risks of heart attack, heart failure, stroke, and kidney disease.
- Each increase of 20 mmHg in systolic BP (SBP) or 10 mmHg in diastolic BP (DBP) doubles the risk of cardiovascular disease across the entire BP range from 115/75 mmHg to 185/115 mmHg.
Prehypertension
- Defined as systolic pressure between 120 and 139 mmHg or diastolic pressure between 80 and 89 mmHg
  - This level of blood pressure elevation is also associated with an increased risk of vascular complications, but the benefits of therapy have not been clearly shown to outweigh the risks of pharmacologic intervention.
Labile hypertension
- Arterial pressures are sometimes but not always in the hypertensive range.
Accelerated hypertension
- Significant recent increase over previous hypertensive levels
- Frequently associated with evidence of vascular damage on funduscopic examination
White coat hypertension
- BP measured in the office by a professional that is persistently higher than when measured at home or under casual circumstances
Isolated systolic hypertension
- The predominant form of hypertension after 50 years of age
- Caused by arterial stiffness
Resistant hypertension
- Patients with blood pressures persistently >140/90 mmHg despite taking 3 or more antihypertensive agents, including a diuretic, in reasonable combination and at full doses
For discussion of special situations in hypertension, see:

Essential Hypertension has been found in Harrison's Practice

If you are a registered user, please login below.

If not, learn more about gaining full access.

Login: User Name:

Password:

Forgot your password?
Forgot your username?
Remember Me

Try

Harrison's Practice delivers essential point-of-care information on the diagnosis and management of over 800 medical conditions. Continuously updated and available for desktop and mobile devices.