Hypertension Overview and Classification

Hypertension Overview

• Defined as blood pressure exceeding 130/80 mmHg.
• Most prevalent primary diagnosis in the U.S., affecting around 60 million individuals.
• Approximately 70% are unaware of their hypertensive condition.

Blood Pressure Classification

• Normal: Systolic < 120 mmHg and Diastolic < 80 mmHg.
• Elevated: Systolic 120-129 mmHg or Diastolic < 80 mmHg; lifestyle changes recommended to mitigate risk.
• Stage I Hypertension: Systolic 130-139 mmHg or Diastolic 80-89 mmHg; requires lifestyle advice, possibly antihypertensive medications.
• Stage 2 Hypertension: Systolic ≥ 140 mmHg or Diastolic ≥ 90 mmHg; retake vitals, consult a medical professional if readings persist.

Risks of Untreated Hypertension

• Increases chances of cardiovascular disease (CVD), kidney damage, and cerebrovascular accident (CVA).
• Each 10 mmHg systolic increase above 160 correlates with a 30% higher risk of CVA.
• Hypertension damages cerebral blood vessels, weakening them and leading to lipid accumulation.

Hypertensive Crisis

• Classified as Systolic > 180 mmHg or Diastolic > 120 mmHg.
• Hypertensive Urgency: Not life-threatening but requires prompt action.
• Hypertensive Emergency: Life-threatening, presents similarly to myocardial infarction or CVA.

Hypertensive Urgency

• Symptoms include moderate to severe headache, anxiety, shortness of breath, tinnitus, edema, and epistaxis if BP > 180/110.
• Treatment includes seating the patient upright, checking BP in 5 minutes, seeking immediate medical consultation, and monitoring BP every 5 minutes.

Hypertensive Emergency

• Symptoms involve sudden BP spikes (often around 180/110 to 220/140), dyspnea, chest pain, dysarthria, weakness, along with potential altered consciousness, visual loss, or seizures.
• Treatment involves addressing end organ damage and secondary hypertension, including basic life support, monitoring vitals, and administering oxygen.

Orthostatic Hypotension

• Characterized by a sudden drop in BP due to position change (e.g., from supine to sitting or standing), potentially causing dizziness or loss of consciousness.
• Common causes include prolonged supine positioning, medical conditions, and certain medications.

Symptoms and Treatment

• Symptoms of orthostatic hypotension include dimming vision, decreased hearing, and lightheadedness.
• Treatment involves positioning the patient supine with feet elevated, assessing airway, administering oxygen, and monitoring vital signs. If conditions do not improve, emergency services should be contacted.