Professional Documents
Culture Documents
Classification of blood
pressure levels of the British
Hypertension
Society
Category
Systolic blood pressure
Diastolic blood pressure
(mmHg)
Normal
High-normal
<130
130139
Hypertension
Grade 1 (mild)
140159
Grade 2 (moderate) 160179
Grade 3 (severe)
180
(mmHg)
<85
8589
9099
100109
110
Type of Hypertension:
Primary hypertension
95% of all cases
Secondary hypertension
5% of all cases
Chronic renal disease most common
Treatment
Overview
Goals of therapy
Lifestyle modification
Pharmacologic treatment
Classification and management of BP for adults
Followup and monitoring
Treatment of Hypertension
Diuretic
ACE-Inh
ARB
Beta blocker
Alpha blocker
Direct renin inhibitor
Management of Hypertension
by Blood Pressure
Initial Drug Therapy
Classification
BP Classification
Normal
<120/80 mm Hg
Lifestyle
Modification
Without Compelling
Indication
With Compelling
Indication
Encourage
Prehypertension
120-139/80-89 mm Hg
Yes
Stage 1 hypertension
140-159/90-99 mm Hg
Yes
Thiazide-type diuretics
for most; may consider
ACE-I, ARB, BB, CCB, or
combination
Stage 2 hypertension
160/100 mm Hg
Yes
No drug indicated
Lifestyle Recommendations
for Hypertension: Physical
Activity
Should be prescribed to reduce blood pressure
F
Frequency
Intensity
- Moderate
Time
- 45-60 minutes
Type
Dynamic exercise
- Walking
- Cycling
- Non-competitive swimming
For patients who are prescribed pharmacological therapy: Exercise should be prescribed as adjunctive therapy
Goals of Therapy
Reduce CVD and renal morbidity and mortality.
Treat to BP <140/90 mmHg or BP <130/80 mmHg in patients
with diabetes or chronic kidney disease.
Achieve SBP goal especially in persons >50 years of age.
BP TARGETS:
WITHOUT COMPLICATION : <140/80 mmHg
DIABETES
CKD
: <125/75 mmHg
Lifestyle Modification
Modification
Weight reduction
Dietary sodium
reduction
Physical activity
Moderation of
alcoholconsumption
Approximate SBP
reduction (range)
520 mmHg/10 kg weight loss
28 mmHg
49 mmHg
24 mmHg