Document Detail

Rationale and benefits of classification of hypertension severity.
MedLine Citation:
PMID:  9263648     Owner:  NLM     Status:  MEDLINE    
Classification schemes for hypertension are helpful in defining the condition, quantitating risk, estimating prognosis, and guiding management. Most "classic" systems classify hypertension based on the blood pressure level, according to "relative risk" (the proportional likelihood of cardiovascular events occurring as blood pressure--either systolic, diastolic, or both--rises). Several recent systems are based on "absolute risk," and quantify the risk for adverse events related to other cardiovascular risk factors besides hypertension. Classification schemes based on the pattern of blood pressure elevation, extent of damage to target organs from hypertension, and laboratory evaluations have also been suggested, but are, of necessity, more complicated than systems based simply on the blood pressure readings. Two novel systems of classifying hypertension have recently been proposed, incorporating most of the desirable attributes of the simpler (and widely used) methods of "staging" blood pressure, but adding a subscript to indicate the presence ("c") or absence ("u") of complications or other risk factors present in a given patient. This system also uses a subscript "e" to indicate the presence of a widened pulse pressure (more common in the elderly); such patients are more likely to benefit from hypertension treatment. A complete medical history and physical examination and a few inexpensive laboratory tests provide essentially all the information needed to classify an individual as "complicated" or "uncomplicated." This system also provides a guide to treatment, because drug therapy should be used sooner in those with complicated hypertension. Implementation of this system is likely to be enhanced if compensation for health care providers were higher when treating the higher stages of hypertension, especially an elderly patient with complicated hypertension, compared with a younger person with uncomplicated hypertension.
W J Elliott; H R Black
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  12     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-09-23     Completed Date:  1997-09-23     Revised Date:  2006-05-04    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  368-74     Citation Subset:  IM    
Rush-Presbyteran-St. Luke's Medical Center, Chicago, IL 60612, USA.
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MeSH Terms
Blood Pressure*
Hypertension / classification*,  diagnosis,  physiopathology*

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