Chronic hypertension classification: Difference between revisions

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===Classification of Pathophysiology===
Once the diagnosis of hypertension has been made it is important to attempt to exclude or identify reversible (secondary) causes. 
* Over 90% of adult hypertension has no clear cause and is therefore called essential/primary hypertension.  Often, it is part of the [[metabolic syndrome|metabolic "syndrome X"]] in patients with [[insulin resistance]]: it occurs in combination with [[diabetes mellitus]] (type 2), [[combined hyperlipidemia]] and [[central obesity]].<ref name="pmid16719248">{{cite journal | author = Luma GB, Spiotta RT | title = Hypertension in children and adolescents. | journal = Am Fam Physician | volume = 73 | issue = 9 | pages = 1558-68 | month = may | year = 2006 | id = PMID 16719248}}</ref>
* [[Secondary hypertension]] is more common in pre-adolescent children, with most cases caused by [[renal disease]].
====Essential Hypertension====
Essential hypertension is the most prevalent type of hypertension type, and affects 90-95% of hypertensive patients. Although there are risk factors for essential hypertension (sedentary lifestyle, [[obesity]], increased salt intake, increased [[alcohol]] intake), by definition there is no other disease state responsible for the occurrence of the elevated blood pressure.
====Secondary Hypertension====
Secondary hypertension results from an identifiable cause.  Recognition of secondary hypertension is critical since the management is different than primary or essential hypertension and involves treatment of the underlying cause of the elevated blood pressure. Underlying disorders that account for secondary hypertension include:


==References==
==References==

Revision as of 23:09, 4 November 2013

Hypertension Main page

Overview

Causes

Classification

Primary Hypertension
Secondary Hypertension
Hypertensive Emergency
Hypertensive Urgency

Screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Yazan Daaboul, Serge Korjian

Overview

Blood pressure values for adults have been classified in 2004 according to the Seventh Report of the Joint National Committee (JNC 7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure into normal, prehypertension, stage 1 hypertension and stage 2 hypertension.[1] In Europe, a different classification of blood pressure has been conducted in 2007 by “The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)”.[2] The classification excludes JNC 7’s pre-hypertension category, but includes 3 different grades of hypertension, in contrast to JNC 7’s two-stage classification of hypertension.

Classification

JNC 7 Classification of Blood Pressure or Adults

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure[3] has classified blood pressure as the following:

Blood Pressure Classification Systolic (mm Hg) Diastolic (mm Hg)
Normal < 120 and < 80
Pre-Hypertension 120-139 or 80-89
Stage 1 Hypertension 140-159 or 90-99
Stage 2 Hypertension >160 or >100

European Classification of Blood Pressure

In Europe, a different classification of blood pressure has been conducted in 2007 by The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). According to the 2007 Guidelines for the Management of Arterial Hypertension, the blood pressure classification is as follows: [2]

Blood Pressure Classification Systolic (mm Hg) Diastolic (mm Hg)
Optimal < 120 and < 80
Normal 120-129 and/or 80-84
High Normal 130-139 and/or 85-89
Grade 1 Hypertension 140-159 and/or 90-99
Grade 2 Hypertension 160- 179 and/or 100-109
Grade 3 Hypertension ≥ 180 and/or ≥ 110
Isolated Systolic Hypertension ≥ 140 and <90

References

  1. ↑ Cuddy ML (2005). "Treatment of hypertension: guidelines from JNC 7 (the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 1)". J Pract Nurs. 55 (4): 17–21, quiz 22-3. PMID 16512265.
  2. ↑ 2.0 2.1 Bonny A, Lacombe F, Yitemben M, Discazeaux B, Donetti J, Fahri P; et al. (2008). "The 2007 ESH/ESC guidelines for the management of arterial hypertension". J Hypertens. 26 (4): 825, author reply 825-6. doi:10.1097/HJH.0b013e3282f857e7. PMID 18327095.
  3. ↑ Chobanian AV; et al. (2003). "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report". JAMA. 289: 2560–72. PMID 12748199.

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