From the Guidelines
Hypertension (HTN) is a chronic medical condition characterized by persistently elevated blood pressure in the arteries, typically defined as blood pressure readings consistently at or above 130/80 mmHg, as recommended by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline 1.
Definition and Classification
Hypertension is often classified as primary (essential) hypertension, which develops without an identifiable cause and accounts for about 90-95% of cases, or secondary hypertension, which results from an underlying condition such as kidney disease, hormonal disorders, or certain medications. The top number (systolic pressure) represents the pressure when the heart contracts, while the bottom number (diastolic pressure) indicates the pressure when the heart relaxes between beats.
Risk Factors and Complications
Hypertension significantly increases the risk of serious health complications, including:
- Heart disease
- Stroke
- Kidney damage
- Vision problems by damaging blood vessels throughout the body. According to the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline, hypertension is associated with the development of many comorbid conditions, such as coronary artery disease, heart failure, stroke, peripheral vascular disease, and chronic kidney disease 1.
Management
Management typically involves lifestyle modifications, such as:
- Reducing sodium intake
- Maintaining a healthy weight
- Regular exercise
- Limiting alcohol
- Not smoking and may require medications, such as:
- Diuretics
- ACE inhibitors
- ARBs
- Calcium channel blockers
- Beta-blockers depending on severity and individual factors, as recommended by the 2017 ACC/AHA hypertension guideline 1.
Importance of Early Detection
Early detection of hypertension is vital, as it can lead to asymptomatic secondary hypertension due to an underlying disorder, and routine screening is essential to diagnose the condition, especially in younger patients and African American persons, who are at higher risk of developing hypertension and its complications 1.
From the FDA Drug Label
High Blood Pressure (hypertension) High blood pressure comes from blood pushing too hard against your blood vessels.
- Definition of HTN: High blood pressure (hypertension) occurs when blood pushes too hard against blood vessels.
- Key concept: Hypertension is related to the force of blood against blood vessel walls. 2
From the Research
Definition of HTN
- HTN stands for Hypertension, which is a medical condition characterized by elevated blood pressure levels [ 3 ].
- According to the American Family Physician, more than 70% of adults treated for primary hypertension will eventually require at least two antihypertensive agents to achieve adequate blood pressure control [ 3 ].
Classification and Treatment
- Hypertension can be classified as primary (essential) or secondary, with the former being the most common form [ 4 ].
- Treatment for hypertension typically involves lifestyle modifications and medication, with four main classes of medications used in combination therapy: thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs) [ 3 ].
Effects of Antihypertensive Drug Combinations
- Studies have shown that different combinations of antihypertensive therapy can have varying effects on blood pressure and arterial stiffness [ 5 ].
- A study published in the Medical Archives found that lisinopril, losartan, or valsartan alone or in combination with hydrochlorothiazide, and amlodipine were equally effective in reducing blood pressure and improving arterial stiffness in patients with essential hypertension [ 5 ].
Control of Systolic Hypertension
- Research has also focused on the control of systolic hypertension, with studies suggesting that diuretics and calcium-blocking drugs are more effective in elderly patients at lowering systolic blood pressure [ 6 ].
- The American Journal of Hypertension published a study that found that sequential monotherapy achieved target systolic blood pressure in 29% of patients, while combination therapy was often required to achieve goal blood pressure levels [ 6 ].