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Definition
of hypertension:
systolic blood pressure (SBP) of 140 mm Hg or greater, diastolic blood
pressure (DBP) of 90 mm Hg or greater.
Patients who are using antihypertensive medications are also defined as
being hypertensive.
In cases when one of the SBP and DBP reading is not in the hypertensive
range, then the blood pressure with the higher reading should be used to
define the patient’s blood pressure class.
The
optimal blood pressure is SBP <120 and DBP <80 as long as the blood
pressure (BP) is not too low. The
health care provider should encourage lifestyle modifications.
The goal of treatment is to decrase the BP to <140/90 or
<130/80 in patients with chronic renal disease and/or diabetes.
-Prehypertension
is SBP 120-139 or DBP 80-89. Antihypertensive
medications are only indicated for compelling indications. The health
care provider should encourage lifestyle modifications.
-Stage
1 HTN is SBP 140-159 or DBP 90-99. Thiazide
diuretics are indicated for most people without contraindications to
thiazide diuretics. The health
care provider may consider starting combination medications and/or start
medications for strong indications. In
addition, the health care provider should encourage lifestyle modifications.
-Stage
2 HTN is SBP over or equal to 160 or DBP over or equal
to 100.
Many people require two antihypertensive agents that usually include
an thiazide diuretic and beta-blockers (BB) or Angiotensin-converting
enzyme inhibitors (ACEI) or
Angiotensin II receptor blockers (ARB) or
Calcium channel blocker (CCB).
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