Chapter 119: Hypertension

Chapter 119: Hypertension is a topic covered in the Harrison's Manual of Medicine.

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DEFINITION

Chronic elevation in blood pressure (bp), as defined by 2017 Hypertension Guidelines (Table 119-1). Hypertension is major contributor to cardiovascular diseases and complications; etiology is unknown in 80–95% of pts (“essential hypertension”). Always consider a secondary correctable form of hypertension, especially in pts aged ≤30 or those who become hypertensive after 55. Isolated systolic hypertension (systolic ≥140, diastolic <90) most common in elderly pts, due to reduced vascular compliance.

TABLE 119-1: Definition of Hypertension
CATEGORYSYSTOLIC PRESSURE (mmHg) DIASTOLIC PRESSURE (mmHg)
Normal<120and<80
Elevated120−129and<80
Stage 1 Hypertension130−139or80−89
Stage 2 Hypertension≥140or≥90
Source: Whelton PK, Carey RM, Aronow WS, et al: 2017 Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol 71:e127−e248, 2018.

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