Hypertension Questions & Answers

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Questions & Answers

Overview

What is the prevalence of hypertension (high blood pressure) in the US?

What is the definition of hypertension (high blood pressure)?

How is blood pressure (BP) in adults classified?

What are the causes and prevalence of primary and secondary hypertension (high blood pressure)?

How is hypertension (high blood pressure) evaluated?

How is hypertension (high blood pressure) managed?

Which lifestyle modifications are recommended to lower blood pressure (BP) and decrease cardiovascular disease risk in patients with hypertension (high blood pressure)?

What diet and exercise recommendations should be made for patients with hypertension (high blood pressure)?

Which pharmacologic agents are prescribed to treat hypertension (high blood pressure)?

Which specific drug class recommendations are made based on comorbidities of hypertension (high blood pressure)?

What is the global impact of hypertension (high blood pressure) on public health?

What is the prevalence of hypertension (high blood pressure) awareness of in the US?

For what diseases does hypertension (high blood pressure) represent a modifiable risk factor?

How is the classification system for blood pressure (BP) levels used in clinical practice?

What are the guidelines used to classify blood pressure and hypertension?

What does prehypertension (high blood pressure) indicate?

What is the difference between primary (essential) and secondary hypertension (high blood pressure)?

How are hypertensive emergency and urgency defined?

To what extent and how quickly should blood pressure (BP) be lowered in hypertensive emergencies?

What end-organ damage may occur during a hypertensive emergency?

How have antihypertensive medications affected the incidence and outcomes of hypertensive emergencies?

What is the pathogenesis of essential hypertension (high blood pressure)?

Does hypertension (high blood pressure) have an immunological basis?

What role do T lymphocytes and T-cell–derived cytokines play in hypertension (high blood pressure)?

What is the progression of essential hypertension (high blood pressure)?

What causes elevated cardiac output (high-output hypertension) and what does it lead to?

When does systemic vascular resistance occur and how does it affect cardiac output?

What role does cortisol reactivity play in the development of hypertension (high blood pressure)?

What are the etiologies of primary and secondary hypertension (high blood pressure)?

Is hypertension (high blood pressure) genetic?

Which genetic components of hypertension (high blood pressure) have been identified?

What epigenetic phenomena have been implicated in the pathogenesis of hypertension (high blood pressure)?

Is targeted genetic therapy effective in treating hypertension (high blood pressure)?

What secondary causes of hypertension (high blood pressure) are related to single genes?

What are renal causes of hypertension (high blood pressure)?

What is the prevalence of renovascular hypertension (RVHT)?

How is renovascular hypertension (RVHT) defined?

What are vascular causes of hypertension (high blood pressure)?

What is the prevalence of endocrine causes of hypertension (high blood pressure)?

What is the prevalence of hypertension (high blood pressure) caused by oral contraceptives?

What are the risk factors for oral contraceptive-associated hypertension (high blood pressure)?

Do steroids affect blood pressure (BP)?

What is the effect of NSAIDS on blood pressure (BP)?

What are endogenous hormonal causes of hypertension (high blood pressure)?

What are neurogenic causes of hypertension (high blood pressure)?

Which drugs and toxins cause hypertension (high blood pressure)?

What are causes of hypertension (high blood pressure) other than hormonal, neurogenic, or drug/toxins?

What is obstructive sleep apnea (OSA) and is it a risk factor for hypertension (high blood pressure)?

What is the prevalence of overlap between obstructive sleep apnea (OSA) and hypertension (high blood pressure)?

What does "nondipping" blood pressure (BP) during sleep indicate?

How do apneic episodes affect hypertension (high blood pressure)?

How does continuous airway positive pressure (CPAP) therapy for sleep apnea affect blood pressure (BP)?

What is the most common cause of hypertensive emergency?

What causes hypertensive emergency in patients with no history of chronic essential hypertension (high blood pressure)?

What is the prevalence of hypertension (high blood pressure) in adults in the US?

Is hypertension (high blood pressure) more common in men or women?

What is the global prevalence of hypertension (high blood pressure)?

Has there been an increase or decrease in hypertension (high blood pressure)-related visits and admissions to emergency rooms in the US?

What effect does age have on the prevalence of hypertension (high blood pressure) in men and women?

How does the prevalence of hypertension (high blood pressure) vary among races?

What is the prognosis of hypertension (high blood pressure)?

How do incremental changes in blood pressure (BP) affect mortality risk in ischemic heart disease and stroke?

Does hypertensive retinopathy affect an individual’s risk of stroke?

Does prehypertension affect an individual's risk of stroke?

Which factors affect morbidity and mortality rates of hypertensive emergencies?

How does hypertension (high blood pressure) affect the risks of congestive heart failure, coronary artery disease, and stroke?

How does diabetes mellitus affect the risk of death and cardiovascular events in patients with hypertension (high blood pressure)?

What factors increase the risk of end-stage renal disease (ESRD) in patients with hypertension (high blood pressure)?

Are mortality rates associated with hypertension (high blood pressure) increasing or decreasing?

What are the benefits of successful antihypertensive therapy?

How does patient education affect hypertension (high blood pressure) treatment outcomes?

Which lifestyle modifications decrease the risk of cardiovascular disease in patients with hypertension (high blood pressure)?

Presentation

What is the role of the patient’s medical history following documentation of hypertension (high blood pressure)?

What targets of end-organ damage have been identified in patients with hypertension (high blood pressure)?

What are the major cardiovascular risk factors identified by the JNC 7 guidelines?

What medication, drug, and lifestyle factors should be documented in the history of patients with hypertension (high blood pressure)?

Which medical history findings suggest secondary hypertension (high blood pressure)?

What is "nondipping" in nocturnal blood pressure (BP)?

How is hypertension (high blood pressure) diagnosed?

How is blood pressure (BP) measured accurately?

How accurate are ambulatory or home blood pressure readings (BP)?

What are signs of hypertensive retinopathy in a funduscopic evaluation of hypertension (high blood pressure)?

Is palpation of peripheral pulses necessary in patients with hypertension (high blood pressure)?

What are signs of left ventricular hypertrophy (LVH) in cardiac exam of hypertension (high blood pressure)?

What are the most serious health risks associated with hypertension (high blood pressure)?

At what diastolic or systolic pressure is the associated risk for stroke significant?

What are the main pathologic findings of hypertension (high blood pressure)?

How is the nature, severity, and management of a hypertensive event determined?

How should blood pressure (BP) measurements be taken during a hypertensive emergency?

What is the most common clinical presentations of a hypertensive emergency?

Which cardiovascular diseases are caused by direct or indirect effects of hypertension (high blood pressure)?

Which patients are more likely to present with acute heart failure during a hypertensive emergency?

Which factors have increased awareness of hypertension (high blood pressure) in neonatal ICUs (NICUs)?

What is the incidence of hypertension (high blood pressure) in children?

What percentage of pregnancies are complicated by hypertension (high blood pressure)?

What is the risk of chronic and end-stage renal disease (ESRD) in pregnant women with hypertension (high blood pressure)?

What are the ACOG guidelines for monitoring women with a history of preeclampsia?

How is mineralocorticoid excess secondary to primary hyperaldosteronism characterized?

What is the most common cause of secondary hypertension (high blood pressure)?

What are the common signs and symptoms of primary hyperaldosteronism (PA)?

What is the incidence of primary hyperaldosteronism (PA)?

DDX

What factor is used to detect, evaluate, and treat hypertension (high blood pressure)?

How is ambulatory blood pressure monitoring (ABPM) used?

How much does blood pressure typically drop during the night?

When is ambulatory blood pressure monitoring (ABPM) indicated?

What are the differential diagnoses for Hypertension?

Workup

How is hypertension (high blood pressure) evaluated?

What are the Coronary Artery Risk Development in Young Adults (CARDIA) prediction model criteria and how effective are they?

What is the role of pulse wave analysis in the management of hypertension (high blood pressure)?

Which initial lab tests should be performed for hypertension (high blood pressure)?

Which studies should be performed to identify secondary causes of hypertension (high blood pressure)?

What are the recommendations for microalbuminuria screening?

How is primary hyperaldosteronism detected?

Which urine specimen findings may indicate hyperaldosteronism?

What is the role of CT scanning in the diagnosis of hyperaldosteronism?

Which test is performed to exclude hyperthyroidism as a cause of hypertension (high blood pressure)?

Which tests should be performed when pheochromocytoma is suspected in patients with hypertension (high blood pressure)?

Which tests should be performed to evaluate a hypertensive emergency?

What is the role of noninvasive renal imaging or invasive renal angiography in the evaluation of hypertension (high blood pressure)?

How are renal and pulmonary causes of hypertension (high blood pressure) evaluated?

What is the main indication for echocardiography in patients with hypertension (high blood pressure)?

Treatment

Is diabetes a common comorbidity of hypertension (high blood pressure)?

Does hypertension (high blood pressure) cause congestive heart failure?

How does blood pressure (BP) affect renal function?

What are the 2017 ACC/AHA and ACP/AAFP guidelines on hypertension (high blood pressure)?

How effective are lifestyle modifications in preventing and managing hypertension (high blood pressure)?

What are the cholesterol targets in hypertension (high blood pressure)?

What are the indications for surgery in hypertension (high blood pressure)?

How does sodium chloride intake affect blood pressure (BP)?

How does diet affect blood pressure (BP)?

How does dietary intake of potassium, calcium, and magnesium affect blood pressure (BP)?

How does alcohol consumption affect blood pressure (BP)?

How does dark chocolate affect blood pressure (BP)?

How does a high fructose diet affect hypertension (high blood pressure)?

How does physical activity and/or weight loss affect blood pressure (BP)?

Which drugs classes are recommended for initial treatment of hypertension (high blood pressure)?

Which drugs classes are recommended for use in high-risk conditions resulting from hypertension (high blood pressure)?

Are some antihypertensive drugs more effective than others in providing cardiovascular protection?

When are Ras inhibitors used in the treatment of hypertension (high blood pressure)?

Is benazepril plus amlodipine (B+A) or benazepril plus hydrochlorothiazide (B+H) more effective in adults with high-risk hypertension?

When should a multidrug approach be considered in the treatment of hypertension (high blood pressure)?

What is the prevalence of hypertension (high blood pressure) among individuals with diabetes?

What are the treatment guidelines for hypertension (high blood pressure) in patients with diabetes?

Which drug classes are most effective in treating hypertension (high blood pressure) in patients with diabetes?

Which antihypertensive drug combinations are recommended for treatment of hypertension (high blood pressure) in patients with diabetes?

Is baseline hypertension (high blood pressure) an independent predictor of incident diabetes mellitus (DM)?

How are hypertensive emergencies characterized?

What are examples of hypertensive emergencies?

When is ICU admission indicated for treatment of hypertensive emergencies?

What is the primary factor determining whether acute hypertension is a hypertensive emergency?

What is the initial (first 1-6 hours) treatment for patients with hypertensive emergency?

Once a patient with a hypertensive emergency is stabilized, what is the treatment over the next 48 hours?

What percentage of patients presenting to an emergency department have increased blood pressure (BP) and how are they managed?

What are the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on hypertensive crises and emergencies?

What is the goal of hypertensive treatment in pregnant women?

What blood pressure (BP) levels increase health risks for pregnant women?

What lifestyle modifications should be made by pregnant women with stage 1 hypertension?

Is pharmacologic treatment of hypertension (high blood pressure) effective in reducing the incidence of preeclampsia?

When should antihypertensive therapy be considered in pregnant women?

What is the preferred antihypertensive medication in pregnant women?

How is pediatric hypertension defined in the JNC 7 guidelines?

What are the risk factors for pediatric hypertension (high blood pressure)?

What are the updated definitions of blood pressure (BP) categories and stages in the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines?

What antihypertensive pharmacologic therapy is recommended for children?

What antihypertensive agents are contraindicated in sexual active or pregnant teenaged girls?

How is hypertension (high blood pressure) treated in infants?

What are the ACP/AAFP and JNC 8 guidelines for initiating antihypertensive therapy in older adults?

How does hypertension (high blood pressure) progress in older adults?

Which antihypertensive treatments are recommended in older adults?

How does the presentation and progression of hypertension (high blood pressure) differ in black patients?

Which antihypertensive treatments are most effective in black patients?

What are the ocular manifestations of hypertension (high blood pressure)?

What are the treatment options for patients with ocular hypertension (high blood pressure)?

What are the goals of therapy for renovascular hypertension (RVHT)?

What are the treatment options for renovascular hypertension (RVHT)?

What are the benefits of percutaneous renal artery intervention for patients with renovascular hypertension (RVHT)?

When should surgical revascularization be considered for patients with renovascular hypertension (RVHT)?

What noninvasive therapies are used to treat renovascular hypertension (RVHT)?

When is medical therapy required for renovascular hypertension (RVHT)?

When are ACE inhibitors indicated in treating renovascular hypertension (RVHT)?

What causes of renovascular hypertension (RVHT) and is revascularization helpful?

What causes falsely high blood pressure (BP) readings?

How is resistant hypertension (high blood pressure) defined?

What is the treatment for resistant hypertension (high blood pressure)?

When is catheter-based renal sympathetic denervation indicated in the treatment of hypertension (high blood pressure)?

What new therapies are being investigated for resistant hypertension (high blood pressure)?

What causes resistant hypertension (high blood pressure)?

Do inadequate treatment or patient noncompliance cause resistant hypertension (high blood pressure)?

Does extracellular volume expansion cause resistant hypertension (high blood pressure)?

Which vasoactive substances ingested with antihypertensive drugs cause resistant hypertension (high blood pressure)?

How can secondary causes be excluded when diagnosing resistant hypertension (high blood pressure)?

What percentage of patients with resistant hypertension (high blood pressure) have an elevated apnea/hypopnea index?

When is CPAP indicated in the treatment of resistant hypertension (high blood pressure)?

What is pseudohypertension?

When should pseudohypertension be considered in the differential diagnoses of hypertension (high blood pressure)?

How is suspected pheochromocytoma evaluated?

What is the treatment of choice for pheochromocytoma?

What is the treatment of choice for adrenal pheochromocytoma?

What is the prevalence of primary hyperaldosteronism?

Which findings suggest hyperaldosteronism?

What ratio of plasma aldosterone to renin activity suggests primary hyperaldosteronism?

How is a diagnosis of hyperaldosteronism confirmed?

Which tests are helpful in determining the appropriate therapy for hyperaldosteronism?

When is medical therapy indicated for hyperaldosteronism?

How does surgical resection of adrenal adenomas affect blood pressure (BP)?

What interventions improve blood pressure (BP) control in patients with hypertension (high blood pressure)?

Are patient education, monitoring, and feedback effective interventions for improving hypertension (high blood pressure)?

What should be included in a comprehensive strategy to reduce mortality and morbidity associated with hypertension (high blood pressure)?

Which interventions help prevent hypertension (high blood pressure)?

Guidelines

Which organizations have issued guidelines on screening for hypertension (high blood pressure)?

What are the commonly used systems for classifying blood pressure (BP)?

Which organizations have issued guidelines for target blood pressures?

Is there any benefit to more intensive blood pressure (BP) targets than recommended in existing guidelines?

Which organizations have issued guidelines for the management of hypertension (high blood pressure)?

What are the key findings of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)?

What are the ADA recommendations for the control of hypertension (high blood pressure)?

What are the AHA, ACC, and CDC guidelines for the treatment of hypertension (high blood pressure)?

What are the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) guidelines for the management of hypertension (high blood pressure)?

What are the ASH/ISH guidelines for managing hypertension (high blood pressure)?

What are the VA/DoD guidelines for the management of hypertension (high blood pressure) in primary care settings?

What are the recommendations of JNC 7 and AHA-ASA guidelines for lifestyle modification to lower blood pressure (BP) and decrease cardiovascular disease risk?

What are the AHA-ASA guidelines for the primary prevention of stroke?

What are the ACEP guidelines for ED treatment of hypertensive urgency?

What are the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for hypertensive crises and emergencies?

How are the common systems used to classify hypertensive disorders during pregnancy?

Which organizations have issued guidelines for the management of hypertension (high blood pressure) during pregnancy?

What is the preferred antihypertensive medication for use in pregnant women?

What are the guidelines for the emergency treatment of acute-onset severe hypertension (high blood pressure) during pregnancy?

What blood pressure (BP) targets do guidelines recommend for pregnant patients with diabetes and chronic hypertension?

Medications

Are all antihypertensive agents equally effective?

Which medications are recommended by JNC 7 for the initial pharmacologic management of hypertension (high blood pressure)?

What are the acceptable alternative therapies to a thiazide-type diuretic in patients with hypertension (high blood pressure)?

Which medications in the drug class Diuretics, Thiazide are used in the treatment of Hypertension?

Which medications in the drug class Diuretic, Potassium-Sparing are used in the treatment of Hypertension?

Which medications in the drug class Diuretics, Loop are used in the treatment of Hypertension?

Which medications in the drug class ACEIs are used in the treatment of Hypertension?

Which medications in the drug class ARBs are used in the treatment of Hypertension?

Which medications in the drug class Beta-Blockers, Beta-1 Selective are used in the treatment of Hypertension?

Which medications in the drug class Beta-Blockers, Alpha Activity are used in the treatment of Hypertension?

Which medications in the drug class Beta-Blockers, Intrinsic Sympathomimetic are used in the treatment of Hypertension?

Which medications in the drug class Vasodilators are used in the treatment of Hypertension?

Which medications in the drug class Calcium Channel Blockers are used in the treatment of Hypertension?

Which medications in the drug class Aldosterone Antagonists, Selective are used in the treatment of Hypertension?

Which medications in the drug class Alpha2-agonists, Central-acting are used in the treatment of Hypertension?

Which medications in the drug class Renin Inhibitors/Combos are used in the treatment of Hypertension?

Which medications in the drug class Alpha-Blockers, Antihypertensives are used in the treatment of Hypertension?

Which medications in the drug class Antihypertensives, Other are used in the treatment of Hypertension?

Which medications in the drug class Antihypertensive Combinations are used in the treatment of Hypertension?