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High blood pressure

Classifying hypertension
Related conditions

Classifying hypertension
  • Hypertension (high blood pressure) can be mild, moderate, or severe. The National Heart, Lung, and Blood Institute classifies blood pressure as normal, pre-hypertension, hypertension stage 1, and hypertension stage 2. Normal blood pressure (BP) is a systolic pressure of less than 120 mmHg and a diastolic pressure less than 80 mmHg (120/80 mmHg).
  • Pre-hypertension is when the systolic and diastolic blood pressure is higher than normal (120/80 mm/Hg) but not high enough to be considered high blood pressure (140/90 mm/Hg). Pre-hypertension is a systolic (top number) between 120 and 139 or a diastolic (bottom number) between 80 and 89. For example, blood pressure readings of 138/82, 128/70, or 115/86 are all in the "pre-hypertension" range.
  • Stage 1 hypertension is a systolic pressure between 140 and 159mmHg, or a diastolic pressure between 90 and 99 mmHg or higher.
  • Stage 2 hypertension is a systolic pressure of 160mmHg or higher, or a diastolic pressure of 100 or higher.
  • Both increased systolic and diastolic blood pressures can increase the risk for congestive heart failure (CHF, or problems with the heart pumping blood to the body), heart attack, kidney disease, stroke (neurological damage to the brain due to a lack of oxygen), erectile dysfunction (inability of males to get an erection), amputation of the legs, and blindness.
  • As people become older, the diastolic pressure will begin to decrease and the systolic blood pressure will begin to increase, which may lead to high blood pressure. This disorder is called isolated systolic hypertension

Related conditions
  • Hypertensive emergency: Hypertensive emergency is a life-threatening form of high blood pressure, also known as malignant or accelerated hypertension, and is extremely rare. Uncontrolled blood pressures lead to progressive target organ dysfunction (TOD), or organ damage. Kidneys, brain, and heart can be damaged. Hypertensive emergency affects less than 1% of individuals with high blood pressure. Unlike the more common form of high blood pressure that usually develops over a number of years, this condition is marked by a rapid rise in blood pressure (called a hypertensive emergency), with the diastolic pressure shooting to 120mmHg or higher. Hypertensive emergencies must be treated immediately. Hypertensive emergencies can be caused by a history of kidney disorders, pheochromocytoma (tumor of the adrenal glands), and spinal cord disorders. Hypertensive urgency is a severe elevation of blood pressure, without evidence of organ damage.
  • Medications that may cause a hypertensive emergency include cocaine, monoamine oxidase inhibitors (MAOIs, used in depression), dopamine (an injectable blood pressure raising drug), and oral contraceptives. The abrupt withdrawal of beta-blockers (including propranolol, metoprolol, and amlodipine) and alpha-stimulants (including clonidine), or alcohol may also cause a hypertensive emergency. An intravenous (IV, into the veins) drug called sodium nitroprusside (Nipride®) is used in hypertensive emergencies.
  • Pre-eclampsia: Pre-eclampsia is a condition characterized by high blood pressure during pregnancy along with protein in the urine. It can cause serious complications for the mother and baby. Pre-eclampsia can decrease the supply of blood and oxygen available to the mother and developing child. This may result in conditions such as a lower birth weight and neurological (nervous system) damage. The mother is at risk for kidney problems, seizures, strokes, breathing problems, and even death, in rare instances. The cause of pre-eclampsia is not known. Pre-eclampsia usually occurs during the second half of the pregnancy, and affects about 5% of pregnant women.
  • Pulmonary hypertension: When pressure in the pulmonary circulation (blood flow to and from the lungs) becomes abnormally elevated, it is referred to as pulmonary hypertension. Pulmonary hypertension results from constriction, or tightening of the blood vessels that supply blood to the lungs. As a result, it becomes difficult for blood to pass through the lungs, making it harder for the heart to pump blood forward. This stress on the heart leads to enlargement of the heart and eventually fluid can build up in the liver or tissues, such as in the legs. Affected patients can sometimes notice increasing shortness of breath and dizziness. Pulmonary hypertension can be caused by diseases of the heart and the lungs, such as chronic obstructive pulmonary disease (COPD) or emphysema, sleep apnea (a sleeping disorder characterized by pauses in breathing), failure of the left heart ventricle, recurrent pulmonary embolism (blood clots traveling from the legs or pelvic veins obstructing the pulmonary arteries), or underlying diseases such as scleroderma (scar tissue in the organs).

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.