Asymptomatic hypertension

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JNC-7 Classification

Class Systolic Diasolic Normal <120 and <80 Pre-hypertension 120-130 or 80-89 Stage 1 140-150 or 90-99 Stage 2 ≥ 160 or ≥ 100


Work-Up

<120 diastolic --> home, outpt rx

>210 systolic or >120-130 diastolic --> search end organ

1) Upreg

2) If diastolic >110-120:

  • Chem 7 (creatinine)
  • UA (protein)?
  • ECG?
  • CXR?


Note:

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends an average of 2 or more properly measured, seated blood pressure readings on each of 2 or more office visits to establish the diagnosis


Treatment

  • HCTZ all

(2dary= B-blockers; Ca channel in AA)

(also ACE in CHF, DM)