is defined as a type of hypertension whose clinical course progresses rapidly to death

by Unique Koepp 8 min read

What is hypertension (hypertension)?

Hypertension ̶ or elevated blood pressure ̶ is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases. An estimated 1.13 billion people worldwide have hypertension, most (two-thirds) living in low- and middle-income countries.

Will the new definition of hypertension change the practice of Medicine?

First, this new definition carries with it the implication that nearly one half (approximately 46%) of the United States population could be diagnosed with hypertension. Second, although translation into practice by patients and providers will take some time, the new definition will ultimately result in a change in clinical practice.

What is the pathophysiology of hypertension?

Hypertension causes direct pressure on organs, resulting in necrosis and replacement of cells with scar tissue. c. Hypertension causes thickening of the capillary membranes, leading to hypoxia of organ systems.

What is a hypertensive emergency?

c. Hypertensive emergency, a type of hypertensive crisis, is a situation that develops over hours or days in which a patient's BP is severely elevated with evidence of acute target organ disease (e.g., cerebrovascular, cardiovascular, renal, or retinal). The neurologic manifestations are often

What is hypertension death?

Stage 2 hypertension is defined as a blood pressure at or above 140/90 mmHg. Having hypertension puts you at risk for heart disease and stroke, which are leading causes of death in the United States. In 2019, more than half a million deaths in the United States had hypertension as a primary or contributing cause.

What are the five types of hypertension?

For 95 percent of people with high blood pressure, the cause of their hypertension is unknown — this is called essential, or primary, hypertension....Different Types of HypertensionIsolated systolic hypertension. ... Malignant hypertension. ... Resistant hypertension.

What is the clinical definition of hypertension?

(hy blud PREH-sher) 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. Also called hypertension.

What is white coat hypertension?

June 10, 2019. PHILADELPHIA – White coat hypertension, a condition in which a patient's blood pressure readings are higher when taken at the doctor's office compared to other settings, was originally attributed to the anxiety patients might experience during medical appointments.

What is Type 2 hypertension?

Stage 2 hypertension. More-severe hypertension, stage 2 hypertension is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.

What are the 4 stages of hypertension?

High blood pressure is classified in one of several categories — and those designations can influence treatment. Doctors classify blood pressure into four categories: normal, prehypertension (mild), stage 1 (moderate) and stage 2 (severe).

What are the classifications of hypertension?

The four categories currently used to classify hypertension are normal, prehypertension, and stages 1 and 2 hypertension. The population identified with prehypertension includes a subgroup with early CVD.

What is the new definition of hypertension?

High blood pressure is now defined as readings of 130 mm Hg and higher for the systolic blood pressure measurement, or readings of 80 and higher for the diastolic measurement. That is a change from the old definition of 140/90 and higher, reflecting complications that can occur at those lower numbers.

What is the difference between masked hypertension and white coat hypertension?

Masked hypertension is associated with increased cardiovascular risk in both untreated and treated subjects. In contrast, white-coat hypertension is a cardiovascular risk factor in untreated but not in treated subjects.

What is masked hypertension?

Masked hypertension is defined as a normal blood pressure (BP) in the clinic or office (<140/90 mmHg), but an elevated BP out of the clinic (ambulatory daytime BP or home BP>135/85 mmHg).

What is pseudo hypertension?

Pseudo hypertension (HTN) is a condition in which indirect blood pressure (BP) measured by the cuff method overestimates the true intra-arterial BP. [1] It should be suspected if a patient develops dizziness after the start of antihypertensive or following dose escalation.

What are the complications of hypertension?

What are the complications of uncontrolled hypertension? 1 Chest pain, also called angina. 2 Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart. 3 Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs. 4 Irregular heart beat which can lead to a sudden death.

Which region has the highest prevalence of hypertension?

The prevalence of hypertension varies across regions and country income groups. The WHO African Region has the highest prevalence of hypertension (27%) while the WHO Region of the Americas has the lowest prevalence of hypertension (18%).

What is the systolic blood pressure reading on both days?

Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.

What is the target for noncommunicable diseases?

One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 25% between 2010 and 2025.

What happens when the heart cannot pump enough blood and oxygen to other vital body organs?

The longer the blood flow is blocked, the greater the damage to the heart. Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs. Irregular heart beat which can lead to a sudden death. Hypertension can also burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

Why is it important to check blood pressure?

For this reason, it is essential that blood pressure is measured regularly. When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears.

What is the cause of heart pain?

Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can cause: Chest pain, also called angina.

Introduction

In this perspective, I discuss the rationale for the definition of hypertension and review the evidence for the effect of lowering BP on cardiovascular events and mortality, including landmark studies that compared different levels of BP control on these outcomes.

Why Does the Definition of Hypertension Evolve?

The rationale for the continuing evolution of the definition of hypertension is more aggressive lowering of systolic BP among individuals who are hypertensive over the past five decades.

What Is the Evidence?

Landmark clinical trials over the past 50 years have shown the benefit of pharmacologic lowering of BP for reducing cardiovascular event rates, including stroke, myocardial infarction, and heart failure, as well as cardiovascular death and all cause among various hypertensive populations ( 6 – 8 ).

Does One Size Fit All in the Definition of Hypertension?

The AHA/ACC guidelines committee review considered the fact that the SPRINT did not include people with diabetes or stroke in consideration of defining hypertension and recommendations for intervention.

What Are the Implications for the New Definition of Hypertension?

First, this new definition carries with it the implication that nearly one half (approximately 46%) of the United States population could be diagnosed with hypertension. Second, although translation into practice by patients and providers will take some time, the new definition will ultimately result in a change in clinical practice.

Disclosures

R.D.T. is a consultant for Amgen, Bayer, Boehringer-Ingelheim, Quest, Quintiles, Reata, Relypsa, and Astra-Zeneca.

Acknowledgments

The content of this article does not reflect the views or opinions of the American Society of Nephrology (ASN) or the Clinical Journal of the American Society of Nephrology (CJASN). Responsibility for the information and views expressed therein lies entirely with the author (s).