1. Hypertension = Htn, Essential Hypertension See Also Hypertension in Children Hypertension in Infants Hypertension in Pregnancy Hypertension in Athletes Hypertension in the Elderly Epidemiology Demographics White Adults in US: 20% are hypertensive Black Adults in US: 30% are hypertensive Of all hypertensives, >50% are over age 65 years Outcomes BEST PREDICTOR TO OUTCOME VARIES BY AGE Diastolic Blood Pressure best predictor <50 years SBP and DBP predict outcomes equally ages 50-59 Pulse Pressure best predictor age >60 years Coronary Artery Disease Hypertension Causes 35-45% morbidity and mortality Cerebrovascular Accident Relative Risk increases 1.84 for each 10 mmHg DBP Midlife hypertension raises longterm CVA risk Seshadri (2001) Arch Intern Med 161:2343 Alzheimer's Disease Increased SBP in middle age is predisposing factor Reference (1995) Lancet 346(8991):1647 Kivipelto (2001) BMJ 322:1447 Hypertension Definition See Hypertension Criteria Types Essential Hypertension (Primary Hypertension) Stage 1-2 (DBP 90-104) in 80% of cases ACCELERATED MALIGNANT HYPERTENSION Recent substantial Blood Pressure increase Associated with retinal vessel damage Retinal Hemorrhages Retinal exudates Papilledema Diastolic Blood Pressure over 140 ISOLATED SYSTOLIC HYPERTENSION Systolic Blood Pressure: >160 mmHg Diastolic Blood Pressure: <90 mmHg Risks Coronary Artery Disease Cerebrovascular Accident Onset: 5th decade Affects 11% of those over age 75 years Results from progressive fall in vessel compliance Causes of secondary Hypertension See Hypertension Causes Diagnosis See Hypertension Criteria Hypertension Evaluation Hypertension Evaluation History Hypertension Evaluation Exam Hypertension Evaluation Labs Management See Hypertension Management