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Definition & Criteria for diagnosis of Hypertension

  Systolic pressure

• The blood pressure measured during contraction of the heart (systole). In blood pressure readings, it is normally the higher of the two measurements.

  Diastolic blood pressure

• The lowest level of blood pressure measured between contractions of the heart. Diastolic pressures for a person will vary with age, sex, weight, and emotional state. Other factors that may have an effect are the time of day and whether the person has just finished a meal. In general, normal diastolic pressure for a young, healthy, resting adult is 70 to 80. This is expressed as the second number of the total blood pressure.

  Pulse pressure 

• The difference between the blood pressure while the heart is in contraction (systolic) and the blood pressure while the heart is expanding and filling with blood (diastolic), normally 30 to 40 mm Hg.

  WHO Criteria for diagnosis of hypertension.

1. Hypertension: > 160 / 95 mmHg.

2. Borderline Hypertension: 140 / 90-160 / 95 mm Hg.

3. Normotension (normal blood pressure): <140 / 90 mm Hg.

   (recording to be taken on three separate occasions.)

• An intermittent or sustained elevation in systolic blood pressure (above 140 mm Hg) or diastolic blood pressure (above 90 -95 mm Hg) or a systolic and diastolic pressure 20 mm Hg above the individual's baseline pressure.

• The definition of hypertension can be taken as the level of blood pressure above which investigation and treatment is of proven benefit. Current data suggest that drug treatment is beneficial for those with diastolic pressure of 100 mm Hg, and systolic pressure of 160 mm Hg, up to the age of 80 years.

  Essential hypertension

• The most frequent kind, has no, one known cause, but the risk of it is increased by overweight, a high sodium level in the blood, a high lipid (cholesterol) level, and a family history of high blood pressure.

  Secondary Hypertension

• Hypertension detected more commonly in younger age group, may have a well defined underlying cause. This is called Secondary Hypertension.

• Known causes of hypertension include adrenal problems, over-active thyroid gland, certain pregnancies and kidney disorders etc.

• In secondary hypertension, high blood pressure is linked to diseases of the kidneys, lungs, glands, and vessels.

  Malignant or Accelerated Hypertension.

• Marked by a diastolic pressure higher than 120, severe headaches, blurred vision, and confusion, may result in heart attack or stroke. 

• Malignant or Accelerated Hypertension is defined as hypertension associated with bilateral (both sides) retinopathy (retinal damage in eye due to hemorrhage, exudation of fluid and papilloedema i.e. swelling). In the majority of cases of accelerated (or malignant phase) hypertension, no underlying cause can be found.