Hypertension

In adults 60 years and older, a systolic blood pressure > 150 or a diastolic
blood pressure > 90 is defined as hypertension.

In adults younger than 60 years old, a systolic blood pressure > 140 or a
diastolic blood pressure > 90 is defined as hypertension

Risk Factors:
Hypertension: component of metabolic syndrome
Tobacco use, particularly cigarettes, including chewing tobacco
Elevated LDL cholesterol (or total cholesterol 240 mg/dL) or low HDL
cholesterol:
component of metabolic syndrome
Diabetes mellitus: component of metabolic syndrome
Obesity (BMI 30 kg/m 2): component of metabolic syndrome
Age greater than 55 years for men or greater than 65 years for women:
increased risk
begins at the respective ages; the Adult Treatment Panel III used earlier age
cut points to
suggest the need for earlier action
Estimated glomerular filtration rate less than 60 mL/min
Microalbuminuria
Family history of premature cardiovascular disease (men < 55 years; women
< 65 years)
Lack of exercise
Targets for end organ damage:

Heart: left ventricular hypertrophy, angina/previous myocardial infarction,

previous coronary revascularization, and heart failure
Brain: stroke or transient ischemic attack, dementia
Chronic kidney disease
Peripheral arterial disease
Retinopathy

Reveal identifiable causes of high blood pressure such as:

sleep apnea
chronic kidney disease
primary aldosteronism
renovascular disease
pheochromocytoma
coarctation of the aorta
thyroid/parathyroid disease
Causes of Hypertension:
95 - 98% of the hypertension in the United States is essential hypertension
- chronically
higher blood pressure readings than normal with no underlying identifiable
cause.
Causes of Secondary HTN:
Identifiable causes of hypertension are far less common and are known as
secondary
hypertension.
sleep apnea
chronicrenaldisease
renovascular
druginduced
pheochromocytoma
primaryaldosteronism
chronicsteroiduse
Cushing'ssyndrome
Thyroid/parathyroiddisease
coarctationoftheaorta