Multilingual Support:

Concerns

Is your high blood pressure controlled or uncontrolled?

Hypertensive urgency

Hypertensive emergency

For how long have you had high blood pressure?

What medications are you taking?

Have you been diagnosed with any target organ disease?

Do you have any signs or symptoms of high blood pressure?

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Is your high blood pressure controlled or uncontrolled?

According to the latest blood pressure classification The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, JNC 7, controlled blood pressure is defined as a systolic pressure below 140 mm Hg and a diastolic pressure below 90 mm Hg (<140/90 mm Hg). For patients with diabetes or chronic kidney disease, controlled BP is defined <130/80 mm Hg.

Hypertensive urgency

Systolic blood pressure >180 mm Hg or diastolic blood pressure >100 mm Hg without associated organ damage.

Signs and symptoms may include:

  • severe headache
  • shortness of breath
  • nosebleed (epistaxis)
  • mounting anxiety

Treatment

  • adjustment of medications
  • medical evaluation
Alert!

Hypertensive emergencies are associated with adverse acute events.

Hypertensive emergency

Systolic blood pressure usually >180 mm Hg or diastolic blood pressure>120 mm Hg, or at lower levels in persons without a history of high blood pressure, and is associated with organ damage.

Comorbidities may include:

  • aortic dissection
  • kidney damage, with or without loss of kidney function
  • damage to the eyes
  • pulmonary edema
  • eclampsia

Treatment

  • Immediate care is required, especially if symptoms of organ damage may be present. These include:
    - chest pain
    - shortness of breath
    - back pain
    - numbness/weakness
    - change in vision
    - difficulty speaking
Alert!

Hypertensive emergencies are associated with adverse acute events.

For how long have you had high blood pressure?

The longer a patient has been suffering from high blood pressure, the higher the risk of developing target organ diseases (see below).

What medications are you taking?

Blood pressure medications can be divided into several different classes.

Most patients will take two medications, one of which is a thiazide diuretic.

Side effects of these medications may include sublingual edema, oral dryness and gingival overgrowth .

Be aware that chronic use of non-steroidal anti-inflammatory drugs may increase the risk of cardiovascular events in elderly patients with hypertension.

Have you been diagnosed with any target organ disease?

Over time,continued high blood pressure will cause damage to certain organs in the body. These are the “target organs” which may develop target organ disease or damage.

A systolic blood pressure >150 mm Hg may predispose a patient with a recent (within 120 days) non-cardio-embolic ischemic stroke to a recurrent stroke.

Do you have any signs or symptoms of high blood pressure?

Signs and symptoms that may develop when BP is uncontrolled include:

  • retinal hemorrhage
  • papilledema
  • hematuria
  • proteinuria
  • occipital headache
  • failing vision
  • tinnitus
  • dizziness
  • weakness and paresthesia of the extremities
  • CHF
  • angina
  • renal failure.

OK