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In contrast there is no evidence that blood pressure needs to be lowered rapidly in hypertensive urgencies, where there is no evidence of target organ damage; over-aggressive reduction of blood pressure is not without risks. [3] Use of oral medications to lower the BP gradually over 24 to 48h is advocated in hypertensive urgencies. [4]
Blood pressure targets [7] <1 hr 25% reduction in the mean arterial pressure, diastolic blood pressure above 100 2-6 hr Systolic BP < 160 mmHg or Diastolic BP <110 mmHg 6-24 hr monitor BP targets, ensure non-rapid drop in BPs below 160 SBP or 100 DBP 1-2 d if no end-organ damage, monitor out-patient and JNC8 Guidelines for maintaining BP control
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]
In hypertensive encephalopathy, generally the blood pressure is greater than 200/130 mmHg. [1] Occasionally it can occur at a BP as low as 160/100 mmHg. [4] This can occur in kidney failure, those who rapidly stop blood pressure medication, pheochromocytoma, and people on a monoamine oxidase inhibitor (MAOI) who eat foods with tyramine. [2]
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]
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Blood pressure is classified as normal blood pressure, prehypertension, hypertension (stages I and II), and isolated systolic hypertension, which is a common occurrence among the elderly. These readings are based on the average of seated blood pressure readings that were properly measured during 2 or more office visits.
Labile hypertension occurs when there are unexpected changes in blood pressure.The term can be used to describe when people have blood pressure measurements that abruptly fluctuate from being abnormally high, approximately 140/90mm Hg or over and returns to its normal range.