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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]
In addition, hypertension precedes heart failure in 90% of cases, [7] and the majority of heart failure in the elderly may be attributable to hypertension. [17] Hypertensive heart disease was estimated to be responsible for 1.0 million deaths worldwide in 2004 (or approximately 1.7% of all deaths globally), and was ranked 13th in the leading ...
The 8th Joint National Committee (JNC-8) recommends calcium channel blockers to be a first-line treatment either as monotherapy or in combination with thiazide-type diuretics, ACEis, or ARBs for all patients regardless of age or race. [7] The ratio of CCBs' anti-proteinuria effect, non-dihydropyridine to dihydropyridine was 30 to −2. [13]
Prehypertension, also known as high normal blood pressure and borderline hypertensive (BH), [1] is a medical classification for cases where a person's blood pressure is elevated above optimal or normal, but not to the level considered hypertension (high blood pressure).
Guidelines in the United States recommend thiazides as a first-line treatment for hypertension (JNC VIII). [12] A systematic review by the Cochrane Collaboration specifically recommended that low-dose thiazides be used as the initial pharmacological therapy for high blood pressure. [ 9 ]
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Hypertensive urgency is defined as severely high blood pressure with no evidence of end organ damage. [3] The term "malignant hypertension" was also included under this category with grade III/IV hypertensive retinopathy.