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Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
This is in contrast to type 1 diabetes in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas and gestational diabetes that is a new onset of high blood sugars associated with pregnancy. [13] Type 1 and type 2 diabetes can typically be distinguished based on the presenting circumstances. [66]
For mild blood pressure elevation, consensus guidelines call for medically supervised lifestyle changes and observation before recommending initiation of drug therapy. However, according to the American Hypertension Association, evidence of sustained damage to the body may be present even prior to observed elevation of blood pressure.
The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit [6] [16] [17] and others finding unclear benefit. [18] [19] [20] High blood pressure affects 33% of the population globally. [9] About half of all people with high blood pressure do not know that they have it. [9]
The health care provider usually takes 2–3 readings at several medical appointments to diagnose high blood pressure. [39] Using the results of the blood pressure test, the health care provider will diagnose prehypertension or high blood pressure if: For an adult, systolic or diastolic readings are consistently higher than 120/80 mmHg.
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