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.
|
Category |
Systolic Blood Pressure, mm Hg |
Diastolic Pressure in mm Hg |
|
normal |
< 130 |
< 85 |
|
high normal |
130-139 |
85-89 |
|
hypertension, stage 1 (mild) |
140-159 |
90-99 |
|
hypertension, stage 2 (moderate) |
160-179 |
100-109 |
|
hypertension, stage 3 (severe) |
180-209 |
110-119 |
|
hypertension, stage 4 (very severe) |
>= 210 |
>= 120 |
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.
|
Organ System |
Manifestation |
|
cardiac |
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 |
|
cerebrovascular |
transient ischemic attack |
|
|
stroke |
|
peripheral vascular |
absence of 1 or more major pulses in extremities (except dorsalis pedis), with or without intermittent claudication |
|
|
aneurysm |
|
renal |
serum creatinine >= 130 µmol/L (1.5 mg/dL) |
|
|
proteinuria 1+ or greater |
|
|
microalbuminuria |
|
retinopathy |
hemorrhages with or without papilledema |
|
|
exudates with or without papilledema |
Follow-up Recommendations
Recommendations for patient follow-up depends on the magnitude of any abnormalities in systolic and/or diastolic pressures.
|
Systolic Blood Pressure, mm Hg |
Diastolic Pressure in mm Hg |
Follow-up Recommended |
|
< 130 |
< 85 |
recheck in 2 years |
|
130-139 |
85-89 |
recheck in 1 year |
|
140-159 |
90-99 |
confirm within 2 months |
|
160-179 |
100-109 |
evaluate or refer to source of care within 1 month |
|
180-209 |
110-119 |
evaluate or refer to source of care within 1 week |
|
>= 210 |
>= 120 |
evaluate or refer to source of care immediately |
Purpose: To diagnose hypertension in the adult by a careful assessment of the clinical data.
Specialty: Cardiology
Objective: other testing, severity, prognosis, stage
ICD-10: I10, I11, I12, I13, I15,
