Essential Hypertension

Definition

Chronic elevation in blood pressure (BP) > 120/80 mmHg with no definable cause

o Represents 90–95% of hypertensive persons
o The remainders have identifiable causes (secondary hypertension).
Importance of hypertension relates to increased risks of heart attack, heart failure, stroke, and kidney disease.
o Each increase of 20 mmHg in systolic BP (SBP) or 10 mmHg in diastolic BP (DBP) doubles the risk of cardiovascular disease across the entire BP range from 115/75 mmHg to 185/115 mmHg.

Types

• Labile hypertension
o Arterial pressures are sometimes but not always in the hypertensive range.

• Accelerated hypertension
o Significant recent increase over previous hypertensive levels
o Frequently associated with evidence of vascular damage on funduscopic examination

• White coat hypertension
o BP measured in the office by a professional that is persistently higher than when measured at home or under casual circumstances

• Isolated systolic hypertension
o The predominant form of hypertension after 50 years of age
o Caused by arterial stiffness

MANAGEMENT

Drugs
Low salt diet
Stress management
Weight Management