What is the score test for hypertension (HTN)?

From the Guidelines

The SCORE test is not directly mentioned in the provided evidence as a score test for hypertension (HTN), but rather as a risk assessment tool used to predict the 10-year risk of fatal cardiovascular disease in patients. To assess the risk of hypertension, several factors are considered, including age, gender, smoking status, systolic blood pressure, and total cholesterol levels, as mentioned in the general knowledge of risk assessment tools like the SCORE test 1. The evidence provided discusses the definition, classification, and management of hypertension, emphasizing the importance of considering total cardiovascular risk when making treatment decisions 1. Key points to consider when assessing hypertension risk include:

• Age: Hypertension risk increases with age
• Gender: Hypertension risk varies between men and women
• Smoking status: Smoking increases cardiovascular risk
• Systolic blood pressure: Elevated systolic blood pressure is a major contributor to cardiovascular risk
• Total cholesterol levels: High cholesterol levels increase cardiovascular risk Based on the most recent and highest quality study, the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline, the focus should be on assessing and managing patients with high blood pressure, taking into account their overall cardiovascular risk 1. This approach allows clinicians to move beyond treating just the blood pressure number to addressing overall cardiovascular risk, enabling more personalized and effective hypertension management strategies. It is essential to note that the SCORE test, as a risk assessment tool, is not explicitly mentioned in the provided evidence as a score test for hypertension, but its concept is relevant when considering the management of hypertension and cardiovascular risk.

From the Research

Definition and Diagnosis of Hypertension

• Hypertension is defined as persistent systolic blood pressure (SBP) at least 130 mm Hg or diastolic BP (DBP) at least 80 mm Hg 2
• It can also be defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg 3

Blood Pressure Goals

• The recommended blood pressure goal is less than 140/90 mm Hg for most adults 4, 5
• For adults older than 65 years, the recommended systolic blood pressure goal is less than 130 mm Hg 2
• Lowering blood pressure to less than 135/85 mm Hg may further reduce the risk of myocardial infarction 4

Lifestyle Modifications

• Lifestyle modifications are recommended as first-line therapy for hypertension, including weight loss, healthy dietary pattern, physical activity, and moderation or elimination of alcohol consumption 2, 3, 4, 6
• Specific dietary recommendations include the Dietary Approaches to Stop Hypertension (DASH) diet, dietary sodium restriction, and potassium enrichment 4, 5, 6

Pharmacologic Therapy

• First-line drug therapy for hypertension consists of a thiazide or thiazide-like diuretic, an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and a calcium channel blocker 2, 4, 5
• The decision to initiate antihypertensive medication should be based on the level of BP and the presence of high atherosclerotic CVD risk 2

Score Test for Hypertension

• There is no specific "score test" for hypertension mentioned in the provided studies 2, 3, 4, 5, 6
• Diagnosis and management of hypertension are based on blood pressure measurements, lifestyle modifications, and pharmacologic therapy, rather than a specific score test.