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Hypertension Criteria

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Hypertension Criteria, Hypertension Reduction Goal, High-Normal Blood Pressure, Stage 1 Hypertension, Stage 2 Hypertension, Stage 3 Hypertension, Stage 4 Hypertension

  1. Background
    1. The Running tally of goal BP changes to guidelines every few years is listed below
    2. Are these goal changes sound?
      1. http://ja.ma/2DeCBTs
  2. ACC/AHA Guidelines 2017 (AAFP and ADA recommend JNC-8 guidelines)
    1. BP <120/80 (normal)
      1. Goal ideal Blood Pressure
    2. BP >=120/80 (elevated)
      1. Lifestyle changes and evaluate for Medication Causes of Hypertension
    3. BP >=130/80 (Stage 1 Hypertension)
      1. Start antihypertensives in cardiovascular disease, Diabetes Mellitus, Chronic Kidney Disease, >10% CV risk
    4. BP >140/90 (Stage 2 Hypertension)
      1. Start antihypertensives if not already started
    5. References
      1. http://hyper.ahajournals.org/content/early/2017/11/10/HYP.0000000000000065
  3. JNC-8 Blood Pressures goals (modified as of 2013)
    1. Renal Insufficiency: <140/90 mmHg
    2. Diabetes Mellitus: <140/90 mmHg
      1. ADA recommends <140/80 mmHg
      2. Age >80 years: <150/90 mmHg
    3. No Diabetes Mellitus or renal disease
      1. Age <60 years: <140/90 mmHg
      2. Age >60 years: <150/90 mmHg
    4. References
      1. James (2014) JAMA 311(5):507-20 [PubMed]
  4. Goal Blood Pressures for Hypertensive Patients (JNC-7 Guidelines)
    1. Hypertension without Co-morbidity: <140/90
    2. Diabetes Mellitus: <130/80
    3. Congestive Heart Failure: <130/80
    4. Renal Insufficiency: <130/80
    5. Renal Failure and >1g Proteinuria/24 hours: <125/75
  5. JNC-7 Blood Pressure definitions
    1. Optimal Blood Pressure: <115/80
    2. Normal Blood Pressure: <120/80
    3. Pre-Hypertension: 120-139/80-89
    4. Stage 1 Hypertension: 140-159/90-99
    5. Stage 2 Hypertension: >160/100
  6. Stages eliminated in JNC-7
    1. Stage 3 Hypertension: 180-209/110-119
    2. Stage 4 Hypertension: >210/120
  7. Isolated Systolic Hypertension
    1. Systolic Blood Pressure: >140 mmHg
    2. Diastolic Blood Pressure: <90 mmHg
  1. Normal Blood Pressure
    1. Blood Pressure <90% for age, height, gender or
    2. Blood Pressure <120/80 for age 13 years or older
  2. Elevated Blood Pressure or Prehypertension
    1. Blood Pressure 90% to 95% for age, height, gender or
    2. Blood Pressure >120/80 mmHg for age 13 years or older
  3. Stage I Hypertension
    1. Blood Pressure 95 to 99% plus 12 mm Hg for age, height, gender or
    2. Blood Pressure >130/80 mmHg for age 13 years or older
  4. Stage II Hypertension
    1. Blood Pressure >99% plus 12 mm Hg for age, height, gender or
    2. Blood Pressure >140/90 mmHg for age 13 years or older
  5. Hypertensive Urgency
    1. Systolic Blood Pressure more than 30 mmHg above 95th percentile or
    2. Systolic Blood Pressure >180/120 mmHg for age 13 years or older
  6. References
    1. Flynn (2017) Pediatrics 140(3): e20171904 [PubMed]
  1. Age 16-18 years
    1. Significant Hypertension: BP> 142/92
    2. Severe Hypertension: BP> 150/98
  2. Age: 13-15 years
    1. Significant Hypertension: BP> 136/86
    2. Severe Hypertension: BP> 144/92
  1. Age 10-12 years
    1. Significant Hypertension: BP> 126/82
    2. Severe Hypertension: BP> 134/90
  2. Age 6-9 years
    1. Significant Hypertension: BP> 122/78
    2. Severe Hypertension: BP> 130/86
  3. Age 3-5 years
    1. Significant Hypertension: BP> 116/76
    2. Severe Hypertension: BP> 124/84
  4. Age 1 month to 2 years
    1. Significant Hypertension: BP> 112/74
    2. Severe Hypertension: BP> 118/82
  5. Age 8-30 days
    1. Significant Hypertension: SBP> 104
    2. Severe Hypertension: SBP> 110
  6. Age <7 day old
    1. Significant Hypertension: SBP> 96
    2. Severe Hypertension: SBP> 106