ChesterCountyMedicineWinter2018 - 9
First the definitions:
Normal BP: Less than 120/80 mmHg
Methodology of treatment is also different, and we have
summarized it below:
Elevated BP: Systolic between 120-129 mm Hg and diastolic less
than 80 mm Hg.
Stage 1 Hypertension: Systolic between 130-139 mm Hg and
diastolic 80-89 mm Hg.
Stage 2 Hypertension: Systolic greater than 140 mm Hg and
diastolic greater than 90 mm Hg.
Hypertensive Crises: Systolic over 180 mm Hg and diastolic
greater than 120 mm Hg.
There are significant changes in the new guidelines with
previous stage 1 now designated as stage 2 and prehypertension
is eliminated. With the new guidelines the prevalence of
hypertension has increased from 39.9% to 45.6% according to
JNC7 by current guidelines [72.2 million to 103.3 million].
They have also stressed the importance of proper technique of
measuring and monitoring the BP.
o Pharmacological treatment for stage 1 hypertension only if
the patient has already had a cardiovascular event like
myocardial infarction, stroke or is at high risk in the
presence of diabetes mellitus, chronic kidney disease, or
high 10-year risk of events based on risk factors. The rest of
stage 1 hypertensive will be treated with lifestyle
modification and close follow up.
o Recognize that two medications may achieve better results.
o Socioeconomic and psychosocial factors should be taken
o Life style modification with diet, exercise and weight loss
are very important part of guidelines.
continued on next page
WINTER 2018 | CHESTER COUNT Y Medicine 9