Hypertension: Difference between revisions
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[[NICE]] and the [http://www.bhsoc.org/ British Hypertension Society]] (BHS) each came up with a set of guidelines regarding the management of hypertension. They came up with this algorithm: | [[NICE]] and the [http://www.bhsoc.org/ British Hypertension Society]] (BHS) each came up with a set of guidelines regarding the management of hypertension. They came up with this algorithm: | ||
[[image:niceguidelines.gif|right|thumb|400px|<font color=red>A=ACE Inhibitors</font>; <font color=steelblue>C=Calcium-Channel Blocker</font>; and <font color=green>D=Thiazide Diuretic</font>]] | [[image:niceguidelines.gif|right|thumb|400px|<font color=red>A=ACE Inhibitors</font>; <font color=steelblue>C=Calcium-Channel Blocker</font>; and <font color=green>D=Thiazide Diuretic</font>]] | ||
Revision as of 15:30, 24 March 2009
Definition
High blood pressure. According to NICE, it has to be persistenly over 140/90mmHg.
Epidemiology
Ridiculously high prevalence - 11.3%. 95% is primary (i.e. no known cause).
Pathophysiology
There are two types :
- essential (aka primary or systemic) - it just happens and nobody knows the cause.
- secondary - caused by another disease.
Risks
Risk Factors
Nobody knows the exact cause of hypertension but there are some risk factors:
- Diet - high salt, calcium and coffee intake
- Genetics
- Oral contraceptive
- HRT
Associated Risks
Hypertension is massively associated with cardiovascular disease which is why it is so important. It increase the risk of:
Clinical Features
The main clinical feature of high blood pressure is high blood pressure. Go figure. Well, I'm sure you did. This is about excluding secondary hypertension.
Classification
| Category | Systolic blood pressure (SBP) | Diastolic blood pressure (DBP) |
|---|---|---|
| Normal | ||
| Optimal | <120 | <80 |
| Normal | <130 | <85 |
| High normal | 130-139 | 85-89 |
| Hypertension | ||
| Mild (grade 1) | 140-159 | 90-99 |
| Moderate (grade 2) | 160-179 | 100-109 |
| Severe (grade 3) | >/=180 | >/=110 |
Investigations
These are more appropriate if secondary hypertension is suspected. I'd look at the secondary hypertension page if I were you.
Management
NICE and the British Hypertension Society] (BHS) each came up with a set of guidelines regarding the management of hypertension. They came up with this algorithm:
