SECTION: Cardiology

Scheme Name: Hypertension

Page: 8


Definition of hypertension:

Systolic BP ≥ 140 mmHg or Diastolic BP ≥ 90 mmHg

Isolated systolic hypertension in the elderly ≥ 160 mmHg

Diabetes mellitus ≥ 130/80 mmHg


Branch 1: Primary (Essential) (95%)

Onset between age 20 and 50

Positive family history

No features of secondary hypertension


  • Long-standing
  • Uncontrolled
  • Drug Withdrawal


Branch 2: Secondary (5%)

Onset age <20 or >50 years

No family history. Hypertensive urgency.

Resistant hypertension



Clinical Pearl: In children, the definition of hypertension is different (either systolic or diastolic BP >95%ile), but the approach is the same.

Hypertension primary essential 95% onset between age 20 and 50 positive family history no features of secondary hypertension long-standing uncontrolled drug withdrawal secondary 5% on that age less than 20 or greater than 50 years no family history hypertensive urgency resistant hypertension exgenous corticosteroids oral contraceptive pills cocaine black liquorice medication's Reno Reno parenchymal disease CKD AKI glomerulonephritis Renovascular disease( unilateral and bilateral renal artery stenosis) mechanical aortic coarctation obstructive sleep apnoea endocrine glucocorticoid excess cushing syndrome or disease) catechol amine excess (pheochromocytoma) mineralocorticoid excess (primary aldosteromism) hyperthyroidism (mainly systolic hypertension) hypothyroidism )mainly diastolic hypertension) hyperparathyroidism pregnancy (gestational hypertension) definition of hypertension systolic BP greater than or equal 140mmHg or Diastolic BP greater than equal 90mmHg isolated systolichypertension in the elderly greater than equal to 160mmHg diabetes mellitus greater than equal to 130/80mmHg note in children the definition of hypertension is different (either systolic or diastolic BP greater than 95th percentile but the approach is the same. hypertensive urgency BP usually greater than 180/110mmHg or asymptomatic diastolic BP > 130mmHg with target organ damage usually present but not acutely changing Hypertensive emergency BP usually greater than 220/140mmHg with evolving target organ damage

Related resources