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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

  • See Also
  1. Medication Causes of Hypertension
  2. Pregnancy Induced Hypertension
  3. Hypertension
  4. Hypertension Evaluation
  5. Hypertension Evaluation History
  6. Hypertension Causes
  7. Evaluation Exam
  8. Hypertension Evaluation Labs
  9. Isolated Systolic Hypertension
  10. Hypertension Management
  11. Hypertension Risk Stratification
  12. Resistant Hypertension
  13. Antihypertensive Selection
  14. Hypertension Management for Specific Comorbid Diseases
  15. Hypertension Management for Specific Populations
  16. Hypertension Management for Specific Emergencies
  17. Hypertension in Children
  18. Hypertension in Infants
  19. Hypertension in Pregnancy
  20. Hypertension in Athletes
  21. Hypertension in the Elderly
  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
  • Resources
  1. http: //www.nhlbi.nih.gov/health/prof/heart /hbp/hbp_ped.pdf
  • Reference
  1. (1987) Pediatrics 79(1):1-25 [PubMed]
  2. (1997) Arch Intern Med 157:2413-46 [PubMed]
  3. (2000) NKF Consensus Report