Cardiovascular Medicine Book

Approach

Causes

Criteria

Evaluation

Management

Information Resources

Endocrinology Chapter related topics

Examination Chapter related topics

Ophthalmology Chapter related topics

Geriatric Medicine Chapter related topics

Pulmonology Chapter related topics

Neurology Chapter related topics

Neonatology Chapter related topics

Obstetrics Chapter related topics

Pediatrics Chapter related topics

Pharmacology Chapter related topics

Prevention Chapter related topics

Sports Medicine Chapter related topics

http://www.fpnotebook.com/

Hypertension Management

Aka: Hypertension Management
  1. See Also
    1. Hypertension
    2. Hypertension Criteria
    3. Hypertension Evaluation
    4. Hypertension Risk Stratification
  2. Management: General Guidelines
    1. See patients back at one month after starting agent
      1. Significantly improves compliance
      2. BP requires 1 month on agent to equilibrate
    2. Maximize compliance
      1. Work with patients to reduce adverse effects
      2. Switch to other agents if adverse effects significant
    3. Do not be overzealous
      1. Risk of overcorrection of Blood Pressure
      2. Avoid lowering diastolic pressure <70 mmHg
      3. Greater tolerance for elevated BP with increased age
        1. Study of 484 Swedish men over 70 from 1982-1992
        2. Risk if Diastolic Blood Pressure lowered below 90
          1. Increased cardiac event risk 3.9x
          2. Controlled for confounding factors
        3. Reference
          1. Merlo (1996) BMJ 313:457-61
    4. Medications that prevent Hypertension vascular sequelae
      1. Beta-Blockers
      2. Diuretics
      3. ACE Inhibitors
      4. Calcium Channel Blockers
    5. Medications that prevent Left Ventricular Hypertrophy
      1. Most effective at reduced LVH risk
        1. ACE Inhibitors
        2. Diuretics
        3. Beta-Blockers
      2. Least effective at reduced LVH risk
        1. Prazosin
        2. Clonidine
        3. Diltiazem
      3. Reference
        1. Gottdiener (1997) Circulation 95:2007-14
  3. Management: Protocol
    1. See Hypertension Risk Stratification
    2. See Hypertension Reduction Goal
  4. Management: Strategies
    1. Hypertension General Measures
    2. Antihypertensive Selection
    3. Hypertension Combination Therapy
    4. Hypertension Management for Specific Comorbid Diseases
    5. Hypertension Management for Specific Populations
    6. Hypertension Management for Specific Emergencies
  5. References
    1. (2000) Lancet 356:1955-64

Hypertensive disease (C0020538)

Definition (NCI) A disorder characterized by a pathological increase in blood pressure; a repeatedly elevation in the blood pressure exceeding 140 over 90 mm Hg.
Definition (MEDLINEPLUS)

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure.

Your blood pressure reading uses these two numbers, the systolic and diastolic pressures. Usually they are written one above or before the other. A reading of

  • 120/80 or lower is normal blood pressure
  • 140/90 or higher is high blood pressure
  • Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is prehypertension

High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. You can control high blood pressure through healthy lifestyle habits and taking medicines, if needed.

NIH: National Heart, Lung, and Blood Institute
Definition (NCI) A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness.
Definition (CSP) persistantly high arterial blood pressure.
Definition (MSH) Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
Definition (NCI) Pathological increase in blood pressure; a repeatedly elevated blood pressure exceeding 140 over 90 mmHg.
Concepts Disease or Syndrome (T047)
MSH D006973
ICD9 997.91, 401-405.99
ICD10 I10-I15.9, I10, I10-I15
SnomedCT 38341003, 155295004, 194756002, 155302005, 266287006, 195537001, 194794002, 194757006, 194760004
English Hypertension, BLOOD PRESSURE HIGH, HYPERTENSION, HYPERTENSION ARTERIAL, HYPERTENSIVE DISEASES, Hypertension, NOS, Hypertensive disease, NOS, Hypertensive disease NOS, Hypertensive diseases, [X]Hypertensive diseases, hypertension, Hypertension, arterial, Hypertensive cardiovascular disease or syndrome, Systemic hypertension, Hypertensive disorder, systemic arterial, hyperpiesia, hyperpiesis, systemic HTN, systemic hypertension (diagnosis), systemic hypertension, hypertensive disorder, vascular hypertension, 3-02 HYPERTENSIVE DISEASES, hbp, high bp, htn, (Hypertensive disease) or (hypertension) (disorder), Hypertensive disease (disorder), Hypertensive disease NOS (disorder), Hypertension arterial, Blood pressure high, HBP, HT, Hypertension NOS, [X]Hypertensive diseases (disorder), Surg comp - hypertension, HTN, HIGH BLOOD PRESSURE, PRESSURE, HIGH BLOOD, BLOOD PRESSURE, HIGH, High Blood Pressure, INCREASED BLOOD PRESSURE, BLOOD PRESSURE, INCREASED, Hypertension [Disease/Finding], hypertensive vascular disease, arterial hypertension, arterial hypertension systemic, blood high pressure, high blood pressure disorder, systemic arterial hypertension, hypertensive disease, Hypertensive diseases (I10-I15), high blood pressure, High blood pressure, Hyperpiesia, Hyperpiesis, Hypertensive vascular degeneration, Hypertensive vascular disease, BP - High blood pressure, High blood pressure disorder, Systemic arterial hypertension, HBP - High blood pressure, BP+ - Hypertension, HT - Hypertension, Hypertensive disorder, systemic arterial (disorder), Hypertensive disorder, HTN - Hypertension, blood pressure; high, high; arterial tension, high; blood pressure, (Hypertensive disease) or (hypertension), Raised blood pressure (disorder), Blood Pressure, High, Blood Pressures, High, High Blood Pressures, Vascular Hypertensive Disorder, Hypertensive disease, HYPERTENSIVE DISEASE
French HYPERTENSION ARTERIELLE, Pression artérielle élevée, PAH, Hypertension SAI, TH, HYPERTENSION, TENSION ARTERIELLE E, Hypertension chronique, Hypertension permanente, Hypertension artérielle, Hypertension
Portuguese HIPERTENSAO, Hipertensão arterial NE, Hipertensão arterial, Pressão arterial alta, HYPERTENSAO ARTERIAL, PRESSAO SANGUINEA ELEVADA, Pressão Arterial Alta, Pressão Sanguínea Alta, Hipertensão
Spanish HIPERTENSION, PRESION SANGUINEA ALTA, Presión sanguínea alta, HTA, Hipertensión NEOM, Hipertensión arterial, HT, Hypertension, Hypertensive disease, High blood pressure, (Hypertensive disease) or (hypertension), Hypertension NOS, HIPERTENSION ARTERIAL, [X]enfermedades hipertensivas (trastorno), [X]enfermedades hipertensivas, Hypertensive disease NOS, degeneración vascular hipertensiva, enfermedad hipertensiva, SAI (trastorno), enfermedad hipertensiva, SAI, enfermedad hipertensiva, enfermedad vascular hipertensiva, hiperpiesia, hiperpiesis, hipertensión arterial (trastorno), hipertensión arterial, presión arterial alta, tensión arterial alta, tensión arterial elevada, Hipertension, Hipertensión, Presión Sanguínea Alta, Presion Sanguinea Alta
German HYPERTONIE, Hypertonie, arteriell, Blutdruck, hoch, HBP, HT, Hypertonie NNB, BLUTDRUCK HOCH, HYPERTONIE ARTERIELL, Hypertension, Hypertonie
Dutch hypertensie NAO, hoge bloeddruk, arteriële hypertensie, bloeddruk; hoog, hoog; arteriële druk, hoog; bloeddruk, hypertensie, Bloeddruk, hoge, Hypertensie
Italian Ipertensione (HT), Ipertensione NAS, Pressione del sangue elevata, Ipertensione, Pressione sanguigna alta, Ipertensione arteriosa
Japanese 動脈性高血圧, 高血圧ＮＯＳ, ｺｳｹﾂｱﾂ, ｺｳｹﾂｱﾂNOS, ﾄﾞｳﾐｬｸｾｲｺｳｹﾂｱﾂ, 高血圧, 高血圧症
Swedish Högt blodtryck
Czech hypertenze, Arteriální hypertenze, Vysoký krevní tlak, Hypertenze NOS, Hypertenze, vysoký krevní tlak
Finnish Kohonnut verenpaine
Russian GIPERTENZIIA, GIPERTONICHESKAIA BOLEZN', KROVIANOE DAVLENIE VYSOKOE, ГИПЕРТЕНЗИЯ, ГИПЕРТОНИЧЕСКАЯ БОЛЕЗНЬ, КРОВЯНОЕ ДАВЛЕНИЕ ВЫСОКОЕ
Croatian HIPERTENZIJA
Polish Nadciśnienie
Hungarian Arteriás hypertonia, Hypertensio, HT, RR magas, Hypertonia k.m.n., Magas vérnyomás
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Navigation Tree