Chronic hypertension screening

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Chronic Hypertension Microchapters

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2017 ACC/AHA Hypertension Guidelines

Patient Information

Overview

Definition

Classification

Pathophysiology

Causes

Differentiating Hypertension from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Blood Pressure Measurement

Physical Examination

Laboratory Findings

Electrocardiogram

ETT

Echocardiography

CT

MRI

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Treatment

Lifestyle Modification

Medical Therapy

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian

Overview

The age to begin screening for hypertension varies between 13-20 years of age, according to different authorities. Generally, hypertension is defined as SBP > 140 mmHg and/or DBP > 90 mmHg. In specific populations, however, routine follow-up target BP may be different; and initiation of treatment may be considered at even lower BP values than those considered for the normal population.

Screening

The age to start screening for hypertension varies according to different authorities:

Authority Age to Start Screening for Hypertension
The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)[1] 20 years
American Heart Association (AHA)[2] 20 years
American Academy of Family Physicians (AAFP)[3] 18 years
American College of Obstetricians and Gynecologists (ACOG)[4] 13 years


The U.S. Preventive Services Task Force (USPSTF)[5] and JNC 7[1] Screening Recommendations

  • If SBP < 120 mmHg and DBP < 80 mmHg: Screening is recommended every 2 years
  • If SBP = 120-139 mmHg and/or DBP = 80-89 mmHg: Screening is recommended yearly
  • If SBP = 140-159 mmHg and/or DBP = 90-99 mmHg: Confirmation of BP values within 2 months is required
  • If SBP = 160-180 mmHg and/or DBP > 110 mmHg: Evaluation or referral to source of care within 1 month
  • If SBP > 180 mmHg: Evaluation and treatment immediately or within 1 week. Clinical situation and complications are to be taken into major consideration.

References

  1. 1.0 1.1 Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL; et al. (2003). "Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure". Hypertension. 42 (6): 1206–52. doi:10.1161/01.HYP.0000107251.49515.c2. PMID 14656957.
  2. Pearson TA, Blair SN, Daniels SR, Eckel RH, Fair JM, Fortmann SP; et al. (2002). "AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee". Circulation. 106 (3): 388–91. PMID 12119259.
  3. U.S. Preventive Services Task Force (2007). "Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement". Ann Intern Med. 147 (11): 783–6. PMID 18056662.
  4. ACOG Committee on Gynecologic Practice (2006). "ACOG Committee Opinion No. 357: Primary and preventive care: periodic assessments". Obstet Gynecol. 108 (6): 1615–22. PMID 17138804.
  5. Ferket BS, Colkesen EB, Visser JJ, Spronk S, Kraaijenhagen RA, Steyerberg EW; et al. (2010). "Systematic review of guidelines on cardiovascular risk assessment: Which recommendations should clinicians follow for a cardiovascular health check?". Arch Intern Med. 170 (1): 27–40. doi:10.1001/archinternmed.2009.434. PMID 20065196.

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