Overview of hypertension in adults
- Jan Basile, MD
Jan Basile, MD
- Professor of Medicine
- Medical University of South Carolina
- Ralph H Johnson Veterans Affairs Medical Center
- Michael J Bloch, MD, FACP, FASH, FSVM, FNLA
Michael J Bloch, MD, FACP, FASH, FSVM, FNLA
- Associate Professor, University of Nevada School of Medicine
- Medical Director, Vascular Care, Renown Regional Medical Center
- Section Editors
- George L Bakris, MD
George L Bakris, MD
- Editor-in-Chief — Nephrology
- Section Editor — Hypertension
- Professor of Medicine
- The University of Chicago
- William B White, MD
William B White, MD
- Section Editor — Hypertension
- Professor of Medicine
- Chief, Hypertension and Clinical Pharmacology
- Calhoun Cardiology Center
- University of Connecticut School of Medicine, Farmington
- Past President
- American Society of Hypertension 2012-2014
- Blood Pressure Monitoring
- Deputy Editors
- Daniel J Sullivan, MD, MPH
Daniel J Sullivan, MD, MPH
- Deputy Editor — Primary Care (Adult)
- Assistant Professor of Medicine
- Harvard Medical School
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
The prevalence of hypertension is high in the United States and worldwide, and treatment of hypertension is the most common reason for office visits of nonpregnant adults to clinicians in the United States and for use of prescription drugs [1,2]. In addition, roughly half of hypertensive individuals do not have adequate blood pressure control. These issues are discussed in detail elsewhere. (See "The prevalence and control of hypertension in adults" and "Patient adherence and the treatment of hypertension".)
This topic provides a broad overview of the definitions, pathogenesis, complications, diagnosis, evaluation, and management of hypertension. Detailed discussions of all of these issues are found separately. The reader is directed, when necessary, to more detailed discussions of these issues in other topics.
Hypertension — The following definitions were suggested in 2017 by the American College of Cardiology/American Heart Association (ACC/AHA) and are based upon the average of two or more properly measured (table 1) readings at each of two or more office visits after an initial screening :
●Normal blood pressure – Systolic <120 mmHg and diastolic <80 mmHg
●Elevated blood pressure – Systolic 120 to 129 mmHg and diastolic <80 mmHgTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Definitions based upon ambulatory and home readings
- White coat hypertension
- Masked hypertension
- Moderate to severe hypertensive retinopathy (formerly called "malignant hypertension")
- Hypertensive emergency
- Hypertensive urgency
- PRIMARY (ESSENTIAL) HYPERTENSION
- Risk factors for primary (essential) hypertension
- SECONDARY OR CONTRIBUTING CAUSES OF HYPERTENSION
- COMPLICATIONS OF HYPERTENSION
- DIAGNOSIS OF HYPERTENSION
- - Blood pressure measurement
- Ambulatory blood pressure monitoring
- Home blood pressure monitoring
- Office-based blood pressure measurement
- Physical examination
- Laboratory testing
- Additional tests
- Testing for secondary hypertension
- Benefits of blood pressure control
- Who should be treated?
- Nonpharmacologic therapy
- Drug treatment
- - General efficacy
- - Initial monotherapy in uncomplicated hypertension
- - Combination therapy
- - Possible benefit from nocturnal therapy
- Goal blood pressure
- Resistant hypertension
- Discontinuing therapy
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS