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Definition of hypertension
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Reading File
Definition of Hypertension
Hypertension is defined as the presence of blood pressure (BP) elevation to a level that places patients at increased risk for target organ damage in several vascular beds, including the retina, brain, heart, kidneys, and large conduit arteries.
— The Washington Manual of Medical Therapeutics
ACC/AHA 2017 Classification (Current Standard)
| Category | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Normal | < 120 | < 80 |
| Elevated BP | 120–129 | < 80 |
| Stage 1 Hypertension | 130–139 | 80–89 |
| Stage 2 Hypertension | ≥ 140 | ≥ 90 |
When systolic and diastolic pressures fall in different categories, the higher category is used to classify BP status.
Key Points
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The 2017 ACC/AHA guidelines lowered the diagnostic threshold for hypertension from the older JNC 7 cutoff of ≥ 140/90 mm Hg to ≥ 130/80 mm Hg, reflecting increasing evidence of cardiovascular risk at lower BP elevations. — ROSEN's Emergency Medicine
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Diagnosis requires two or more readings on two or more separate occasions (averaged).
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In children < 13 years, hypertension is defined as average SBP or DBP at or above the 95th percentile for age, sex, and height, or SBP ≥ 130 / DBP ≥ 80 mmHg. — Harrison's Principles of Internal Medicine, 22E
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White coat hypertension: Office BP meets hypertension criteria but out-of-office BP is normal.
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Masked hypertension: Office BP is normal but out-of-office BP meets hypertension criteria.
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Resistant hypertension: BP remains ≥ 130/80 mm Hg despite use of ≥ 3 antihypertensive agents (one being a diuretic) at maximal doses.
Target Organ Damage (if untreated)
| System | Manifestations |
|---|---|
| Cardiac | Myocardial infarction, LVH, pulmonary edema |
| Cerebrovascular | Stroke, TIA, intracerebral hemorrhage |
| Renal | Proteinuria, azotemia |
| Retina | Hemorrhages, papilledema, exudates |
| Large vessels | Aortic dissection, accelerated atherosclerosis |
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