Elevated blood pressure readings in adults can be categorized based on clinical findings, which must be carefully collected to accurately reflect the patient's condition.
Blood pressure readings:
(1) Both systolic and systolic readings are recorded.
(2) The patient should not taking antihypertensive medication.
(3) The patient should not be acutely ill.
Hypertensive readings should be based on:
(1) The average of 2 or more readings.
(2) Readings are taken on 2 or more visits.
(3) Readings are taken after an initial screening.
Systolic Blood Pressure, mm Hg
Diastolic Pressure in mm Hg
hypertension, stage 1 (mild)
hypertension, stage 2 (moderate)
hypertension, stage 3 (severe)
hypertension, stage 4 (very severe)
The patient is classified by the higher category if the systolic and diastolic pressure categories differ.
If the systolic pressure is elevated but the diastolic blood pressure is < 90 mm Hg, then the hypertension is termed "isolated systolic hypertension."
Target Organ Diseases
Recording of a patient's hypertension should also include the target organ diseases present or absent.
clinical, electrocardiographic or radiologic evidence of coronary artery disease
left ventricular hypertrophy or "strain" by electrocardiography, or left ventricular hypertrophy by echocardiography
left ventricular dysfunction or cardiac failure
transient ischemic attack
absence of 1 or more major pulses in extremities (except dorsalis pedis), with or without intermittent claudication
serum creatinine >= 130 µmol/L (1.5 mg/dL)
proteinuria 1+ or greater
hemorrhages with or without papilledema
exudates with or without papilledema
Recommendations for patient follow-up depends on the magnitude of any abnormalities in systolic and/or diastolic pressures.
recheck in 2 years
recheck in 1 year
confirm within 2 months
evaluate or refer to source of care within 1 month
evaluate or refer to source of care within 1 week
evaluate or refer to source of care immediately
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Purpose: To diagnose hypertension in the adult by a careful assessment of the clinical data.
Objective: other testing, severity, prognosis, stage
ICD-10: I10, I11, I12, I13, I15,