Hypertension

In adults 60 years and older, a systolic blood pressure > 150 or a diastolic blood pressure > 90 is defined as hypertension.

In adults younger than 60 years old, a systolic blood pressure > 140 or a diastolic blood pressure > 90 is defined as hypertension

Risk Factors: Hypertension: component of metabolic syndrome Tobacco use, particularly cigarettes, including chewing tobacco Elevated LDL cholesterol (or total cholesterol ≥240 mg/dL) or low HDL cholesterol:

component of metabolic syndrome Diabetes mellitus: component of metabolic syndrome Obesity (BMI ≥30 kg/m 2): component of metabolic syndrome Age greater than 55 years for men or greater than 65 years for women: increased risk

begins at the respective ages; the Adult Treatment Panel III used earlier age cut points to suggest the need for earlier action

Estimated glomerular filtration rate less than 60 mL/min Microalbuminuria Family history of premature cardiovascular disease (men < 55 years; women < 65 years) Lack of exercise

Targets for end organ damage: Heart: left ventricular hypertrophy, angina/previous myocardial infarction, previous

coronary revascularization, and heart failure Brain: stroke or transient ischemic attack, dementia Chronic kidney disease Peripheral arterial disease Retinopathy

Reveal identifiable causes of high blood pressure such as: sleep apnea chronic kidney disease primary aldosteronism renovascular disease pheochromocytoma coarctation of the aorta thyroid/parathyroid disease

Causes of Hypertension:95 - 98% of the hypertension in the United States is essential hypertension - chronically higher blood pressure readings than normal with no underlying identifiable cause.

Causes of Secondary HTN:Identifiable causes of hypertension are far less common and are known as secondary hypertension.

sleep apnea chronic renal disease renovascular drug-induced pheochromocytoma primary aldosteronism chronic steroid use Cushing's syndrome Thyroid/parathyroid disease coarctation of the aorta