What is hypertension?

From the Guidelines

Hypertension is a common health problem characterized by elevated blood pressure, defined as a systolic blood pressure of 130 mm Hg or greater or a diastolic blood pressure of 80 mm Hg or greater.

Key Points

• Hypertension is a major risk factor for cardiovascular disease, stroke, and kidney disease 1.
• The prevalence of hypertension increases with age, affecting over 75% of adults by the eighth decade of life 1.
• The American College of Cardiology/American Heart Association (ACC/AHA) defines hypertension as a blood pressure of 130/80 mm Hg or greater 1.
• Undiagnosed hypertension is a significant public health concern, particularly in younger patients and African American individuals 1.
• Routine screening and effective management are critical to reducing the long-term morbidity and mortality associated with hypertension 1.

Diagnosis and Management

• The diagnosis of hypertension is based on blood pressure measurements, with a systolic blood pressure of 130 mm Hg or greater or a diastolic blood pressure of 80 mm Hg or greater 1.
• Management of hypertension involves lifestyle modifications and pharmacological treatment, with the goal of reducing blood pressure and preventing cardiovascular complications 1.
• Clinical practice guidelines, such as those from the ACC/AHA and the U.S. Department of Veterans Affairs/Department of Defense, provide evidence-based recommendations for the diagnosis and management of hypertension 1.

From the Research

Definition 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

Prevalence and Impact

• Hypertension affects approximately 116 million adults in the US and more than 1 billion adults worldwide 2
• It is associated with increased risk of cardiovascular disease (CVD) events and death 2, 3, 4, 5
• Hypertension is a leading cause of CVD morbidity and mortality 2, 5

Diagnosis and Treatment

• Diagnosis involves accurate standardized blood pressure (BP) measurement, assessment of the patients' predicted risk of atherosclerotic CVD, and detection of secondary causes of hypertension and presence of comorbidities 5
• Lifestyle changes, including dietary modifications and increased physical activity, are effective in lowering BP and preventing hypertension and its CVD sequelae 2, 3, 4, 5
• Pharmacological therapy is very effective in lowering BP and in preventing CVD outcomes in most patients; first-line antihypertensive medications include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, dihydropyridine calcium-channel blockers, and thiazide diuretics 2, 5

Target Organ Damage

• The heart, kidney, brain, and arterial blood vessels are prime targets of hypertensive damage 6
• Uncontrolled hypertension accelerates the damage to these organs and results in eventual organ failure and cardiovascular death and disability 6
• Evaluation of persons with suspected or established hypertension must include a meticulous search for evidence of target organ damage 6