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Slides on hypertension

1. Hypertension Persistent elevation of arterial blood pressure Major cause of CV, cerebrovascular and renal disease

2. BP Categories (ACC/AHA) Normal: <120/<80 Elevated: 120–129/<80 Stage 1: 130–139 or 80–89 Stage 2: ≥140 or ≥90

3. Etiology Primary (90–95%): lifestyle, genetics Secondary: renal disease, endocrine disorders, meds, OSA

4. Diagnosis ≥2 readings on ≥2 visits ABPM/HBPM preferred when possible Assess comorbidities and target organ damage

5. Investigations CBC, CMP, lipids, fasting glucose TSH, urinalysis, ECG Consider renal US if renal cause suspected

6. Target Organ Damage Heart: LVH, HF, CAD Brain: stroke, TIA Kidney: CKD, proteinuria Eye: hypertensive retinopathy

7. Non‑Drug Therapy DASH diet, salt <2.3 g/day Weight loss, exercise 150 min/week Limit alcohol, stop smoking

8. Drug Therapy First line: thiazides, ACEi/ARB, CCB Black adults: thiazide or CCB preferred CKD/proteinuria: ACEi/ARB obligatory

9. Targets & Follow‑up Goal BP <130/80 for most Low‑risk Stage 1: 3–6 month follow‑up High‑risk or Stage 2: meds + 1 month follow‑up

10. Hypertensive Emergency >180/120 with acute organ damage IV therapy: labetalol, nicardipine, nitroprusside Lower BP by ~25% first hour