Chapter 11: Hypertension

Blood pressure is categorized into four levels: normal, elevated, stage 1, or stage 2 hypertension. Elevated blood pressure is defined as a systolic blood pressure (SBP) of 120 mm Hg to 129 mm Hg, with diastolic blood pressure (DBP) less than 80 mm Hg. Stage 1 hypertension is defined as an SBP between 130 mm Hg and 139 mm Hg or a DBP between 80 mm Hg and 89 mm Hg. Stage 2 hypertension is defined as an SBP greater than or equal to 140 mm Hg or DBP greater than or equal to 90 mm Hg. Secondary causes of hypertension include renal parenchymal or renovascular disease, primary aldosteronism, obstructive sleep apnea, Cushing’s syndrome, pheochromocytoma, hypothyroidism, hyperthyroidism, aortic coarctation, and drugs (steroids and estrogens, alcohol, cocaine, cyclosporine and tacrolimus, sympathomimetics, erythropoietin, licorice, monoamine oxidase inhibitors, tricyclic antidepressants, and nonsteroidal anti-inflammatory drugs). The 2025 hypertension guidelines recommend similar treatment goals for all hypertensive populations. Thiazide diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or calcium channel blockers (CCBs) are the initial agents for treatment of hypertension for patients.