Hypertension
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Hypertension Main page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Hypertension is generally defined as an elevated systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. Hypertension can be chronic or acute. While 95% of the cases of chronic hypertension are primary, 5% of chronic hypertension is secondary to other underlying causes. Hypertensive crisis is the acute elevation of blood pressure and it can be classified into hypertensive emergency or hypertensive urgency when end organ damage is present or absent respectively.
Causes
When a full evaluation yields no clear etiology for the elevated blood pressure, the latter is identified as primary hypertension. Secondary hypertension can be caused by:
- Apnea
- Hyperaldosteronism
- Renal failure
- Coarctation of aorta
- Cushing's syndrome
- Drugs
- Diet
- Pheochromocytoma
- Obesity
- Hyperparathyroidism
For detailed causes of secondary hypertension, click here.
Classification
For more details about each specific type of hypertension, click on the links in blue in the algorithm below.
In order to distinguish primary hypertension from secondary hypertension, click here.
| Hypertension | |||||||||||||||||||||||||||||||
| Chronic hypertension | Hypertensive crisis Acute elevation of blood pressure - Systolic blood pressure >180 mm Hg OR - Diastolic blood pressure >120 mm Hg | ||||||||||||||||||||||||||||||
| Primary hypertension (also known as essential hypertension) (95% of the cases) | Secondary hypertension (5% of the cases) | Hypertensive emergency Evidence of end organ damage | Hypertensive urgency No evidence of end organ damage | ||||||||||||||||||||||||||||
Screening
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.