What are the key indicators of stage 1 hypertension. How does stage 1 hypertension impact cardiovascular health. Why is early intervention crucial for preventing progression to stage 2 hypertension. What lifestyle modifications can effectively manage stage 1 hypertension. When should pharmacotherapy be considered for stage 1 hypertension. How does treating stage 1 hypertension benefit long-term cardiovascular health.

Defining Stage 1 Hypertension: Blood Pressure Thresholds and Risk Factors

Stage 1 hypertension is characterized by blood pressure levels ranging from 130-139 mm Hg systolic or 80-89 mm Hg diastolic. This condition is prevalent in outpatient settings and requires attention due to its potential for progression and associated health risks. Individuals with stage 1 hypertension typically have a less than 10% calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD).

Why is understanding stage 1 hypertension crucial? It serves as an early warning sign for potential cardiovascular issues. Without proper management, stage 1 hypertension often progresses to stage 2 hypertension, significantly increasing the risk of adverse cardiovascular events.

Key Risk Factors for Stage 1 Hypertension:

• Family history of hypertension
• Sedentary lifestyle
• Obesity
• High sodium intake
• Excessive alcohol consumption
• Chronic stress

Identifying these risk factors early can help healthcare providers and patients develop targeted strategies to manage blood pressure effectively.

The Cardiovascular Impact of Stage 1 Hypertension

Stage 1 hypertension, though considered mild compared to more severe forms, still poses significant risks to cardiovascular health. How does it affect the heart and blood vessels? Even slightly elevated blood pressure can lead to increased strain on the arterial walls, potentially causing damage over time.

Research indicates that individuals with stage 1 hypertension have an elevated risk of developing various cardiovascular complications, including:

• Heart disease
• Stroke
• Peripheral artery disease
• Kidney damage

The cumulative effect of prolonged stage 1 hypertension can accelerate the progression of atherosclerosis, leading to a higher likelihood of experiencing major cardiovascular events in the future.

Lifestyle Modifications: The First Line of Defense Against Stage 1 Hypertension

For individuals diagnosed with stage 1 hypertension, lifestyle modifications serve as the cornerstone of initial management. These changes can effectively lower blood pressure and potentially prevent progression to more severe stages of hypertension.

Key Lifestyle Interventions:

1. Dietary Adjustments: Adopting the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, whole grains, and lean proteins while limiting saturated fats and sodium.
2. Regular Physical Activity: Engaging in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week.
3. Weight Management: Maintaining a healthy body mass index (BMI) through balanced nutrition and regular exercise.
4. Sodium Reduction: Limiting daily sodium intake to less than 2,300 mg, with an ideal target of 1,500 mg for many adults.
5. Alcohol Moderation: Restricting alcohol consumption to no more than one drink per day for women and two drinks per day for men.
6. Stress Management: Incorporating relaxation techniques such as meditation, deep breathing exercises, or yoga into daily routines.

How effective are these lifestyle modifications? Studies have shown that consistent implementation of these changes can lead to significant reductions in blood pressure, often sufficient to bring stage 1 hypertension under control without medication.

Monitoring and Evaluating Progress in Stage 1 Hypertension Management

Regular monitoring is essential for assessing the effectiveness of lifestyle modifications in managing stage 1 hypertension. Healthcare providers typically recommend follow-up visits every 3 to 6 months to evaluate blood pressure control and adjust management strategies as needed.

What should patients expect during these follow-up visits? Typically, they include:

• Blood pressure measurements
• Review of lifestyle modification efforts
• Assessment of any new symptoms or concerns
• Adjustment of management plan if necessary

Home blood pressure monitoring can also play a crucial role in tracking progress between office visits. Patients are often encouraged to keep a log of their blood pressure readings to share with their healthcare provider, allowing for more comprehensive assessment and personalized care.

Pharmacotherapy for Stage 1 Hypertension: When to Consider Medication

While lifestyle modifications are the initial approach for managing stage 1 hypertension, some patients may require pharmacological intervention. When should medication be considered? The AHA scientific statement suggests that pharmacotherapy should be contemplated if blood pressure goals are not achieved within 6 months of consistent lifestyle changes.

Factors Influencing the Decision to Start Medication:

• Persistence of elevated blood pressure despite lifestyle modifications
• Presence of other cardiovascular risk factors
• Patient preference and adherence to lifestyle changes
• Overall health status and comorbidities

Which medications are commonly prescribed for stage 1 hypertension? First-line pharmacological options often include:

1. Angiotensin-converting enzyme (ACE) inhibitors
2. Angiotensin receptor blockers (ARBs)
3. Calcium channel blockers
4. Thiazide diuretics

The choice of medication depends on various factors, including the patient’s age, race, comorbidities, and potential side effects. Healthcare providers work closely with patients to find the most appropriate and effective medication regimen.

Long-Term Benefits of Managing Stage 1 Hypertension

Effectively managing stage 1 hypertension offers significant long-term benefits for cardiovascular health. How does early intervention impact future health outcomes? By preventing progression to stage 2 hypertension and maintaining optimal blood pressure levels, individuals can substantially reduce their risk of developing serious cardiovascular complications.

Key Benefits of Timely Stage 1 Hypertension Management:

• Reduced risk of heart attack and stroke
• Preservation of kidney function
• Decreased likelihood of developing heart failure
• Improved overall cardiovascular health and longevity
• Potential reduction in healthcare costs associated with treating advanced hypertension and its complications

Research has consistently shown that maintaining blood pressure within normal ranges can significantly decrease the incidence of major cardiovascular events. This underscores the importance of early detection and management of stage 1 hypertension, even in individuals with a low 10-year ASCVD risk.

Special Considerations for Young Adults with Stage 1 Hypertension

The AHA scientific statement particularly emphasizes the importance of addressing stage 1 hypertension in young adults. Why is this population of special concern? Young adults with stage 1 hypertension often have a low 10-year ASCVD risk but face a higher lifetime risk of cardiovascular complications if their condition remains unmanaged.

Unique Challenges in Managing Hypertension in Young Adults:

• Lower perceived risk of cardiovascular disease
• Difficulty in long-term adherence to lifestyle modifications
• Concerns about long-term medication use
• Balancing treatment with quality of life considerations

Healthcare providers must tailor their approach when managing stage 1 hypertension in young adults, focusing on education about long-term risks and the importance of early intervention. Emphasizing the benefits of lifestyle modifications and their potential to avoid or delay the need for medication can be particularly effective in this age group.

Integrating Technology in Stage 1 Hypertension Management

As healthcare continues to evolve, technology plays an increasingly important role in managing stage 1 hypertension. How can digital tools enhance blood pressure control? Various technological solutions offer patients and healthcare providers new ways to monitor, track, and manage hypertension more effectively.

Innovative Approaches to Hypertension Management:

1. Smartphone Apps: Applications that allow patients to log blood pressure readings, medication adherence, and lifestyle habits, providing a comprehensive overview of their hypertension management efforts.
2. Wearable Devices: Smartwatches and fitness trackers that can monitor heart rate and activity levels, contributing valuable data to overall health assessment.
3. Telehealth Consultations: Virtual visits with healthcare providers, enabling more frequent check-ins and adjustments to management plans without the need for in-person appointments.
4. Remote Patient Monitoring: Systems that allow healthcare providers to receive and analyze patient data in real-time, enabling prompt interventions when necessary.
5. Digital Health Coaching: AI-powered platforms that offer personalized lifestyle recommendations and support for patients managing hypertension.

These technological advancements not only improve the ease and accuracy of blood pressure monitoring but also enhance patient engagement and adherence to treatment plans. By providing real-time feedback and personalized insights, these tools empower individuals to take a more active role in managing their hypertension.

The Role of Patient Education in Successful Hypertension Management

Effective management of stage 1 hypertension relies heavily on patient understanding and engagement. Why is patient education crucial in hypertension care? Informed patients are more likely to adhere to treatment plans, make necessary lifestyle changes, and actively participate in their health management.

Key Components of Hypertension Education:

• Understanding blood pressure readings and targets
• Recognizing the long-term risks of uncontrolled hypertension
• Learning proper techniques for home blood pressure monitoring
• Understanding the importance of medication adherence (if prescribed)
• Identifying and implementing effective lifestyle modifications
• Recognizing signs and symptoms that warrant immediate medical attention

Healthcare providers play a vital role in delivering this education, but additional resources such as support groups, educational materials, and online resources can reinforce these important messages. Empowering patients with knowledge not only improves outcomes but also enhances their overall healthcare experience.

Future Directions in Stage 1 Hypertension Research and Management

As our understanding of hypertension continues to evolve, ongoing research promises to shape future management strategies for stage 1 hypertension. What areas of investigation hold the most promise? Several key directions are emerging in the field of hypertension research and clinical practice.

Emerging Areas of Focus in Hypertension Research:

1. Precision Medicine: Tailoring hypertension treatment based on individual genetic profiles and biomarkers to optimize efficacy and minimize side effects.
2. Novel Pharmacological Approaches: Investigating new classes of antihypertensive medications that target different physiological pathways.
3. Microbiome Studies: Exploring the relationship between gut microbiota and blood pressure regulation, potentially leading to probiotic or dietary interventions.
4. Advanced Imaging Techniques: Developing non-invasive methods to assess vascular health and early signs of hypertension-related organ damage.
5. Artificial Intelligence in Risk Prediction: Utilizing machine learning algorithms to improve the accuracy of cardiovascular risk assessment and treatment planning.

These research directions hold the potential to revolutionize how we approach stage 1 hypertension, potentially leading to more personalized and effective management strategies. As new findings emerge, clinical guidelines will likely evolve to incorporate the latest evidence-based recommendations.

In conclusion, stage 1 hypertension represents a critical juncture in cardiovascular health management. By recognizing its significance, implementing effective lifestyle modifications, considering pharmacotherapy when necessary, and staying informed about the latest developments in hypertension care, both healthcare providers and patients can work together to prevent progression to more severe stages of hypertension and reduce the risk of cardiovascular complications. The ongoing focus on early intervention, personalized care, and patient empowerment promises to improve outcomes and quality of life for individuals diagnosed with stage 1 hypertension.

Managing stage 1 hypertension: Consider the risks, stop the progression

Guidelines to Practice

Abel Hooker, MD, Kevin G. Buda, DO and Maarya Pasha, MD

Cleveland Clinic Journal of Medicine May 2022, 89 (5) 244-248; DOI: https://doi.org/10.3949/ccjm.89a.21101

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ABSTRACT

The 2017 American College of Cardiology and American Heart Association Task Force on Clinical Practice Guidelines on the treatment of hypertension recommended lifestyle modification and monitoring every 3 to 6 months for patients with stage 1 hypertension. However, the guidelines did not include recommendations for patients whose blood pressure is unresponsive to lifestyle therapy. The authors review the updated AHA position statement, which is meant to help clinicians manage patients with stage 1 hypertension and a low 10-year risk of atherosclerotic cardiovascular disease.

KEY POINTS

• There are no national guidelines for the treatment of stage 1 hypertension in patients with a low 10-year risk for cardiovascular disease.

• This population represents an important guideline gap: most patients with stage 1 hypertension progress to stage 2 hypertension, which increases the risk for cardiovascular events.

• Lifestyle modifications and, if these fail, pharmacotherapy can effectively prevent progression from stage 1 to stage 2 hypertension.

• Pharmacologic therapy should be considered in patients with stage 1 hypertension who do not achieve goal blood pressure within 6 months.

Three years after the American College of Cardiology (ACC) and American Heart Association (AHA) Task Force on Clinical Practice Guidelines published their 2017 recommendations for treatment of hypertension,¹ an important guideline gap was identified. The 2017 guidelines recommended lifestyle modification and monitoring every 3 to 6 months for patients with stage 1 hypertension, but they did not include recommendations for managing patients whose blood pressure is unresponsive to lifestyle therapy.

Patients with stage 1 hypertension have blood pressure levels of 130–139/80–89 mm Hg, have less than 10% calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD), and are unable to achieve a blood pressure goal of less than 130/80 mm Hg after 6 months of lifestyle changes. (The ASCVD Risk Estimator Plus is accessible on the ACC website.²)

To clarify the information gap in the 2017 guidelines, the AHA released a scientific statement on the management of hypertension in this specific patient population.³

CLINICAL SETTING

The AHA scientific statement on the management of stage 1 hypertension in adults with a low calculated 10-year ASCVD risk focuses on outpatient management of hypertension.

INTENDED AUDIENCE

While the AHA statement is directed to practicing internists and primary care physicians, it is pertinent to any practicing physician or advanced practitioner engaged in treating adults with hypertension or in the primary prevention of atherosclerotic events. The AHA scientific statement is relevant to all patients with stage 1 hypertension with a low 10-year ASCVD risk and assumes that no secondary causes of hypertension are involved.

WHO WROTE THE GUIDELINES?

The authors of the AHA scientific statement are nephrologists, cardiologists, internists, and a PhD epidemiologist, and the document reflects their consensus opinion. The statement is a comprehensive literature review, but its development did not utilize a more formalized method for preparation, such as the Delphi method.⁴ The AHA supported the development of the scientific statement, and authors’ potential conflicts of interest are listed at the conclusion of the document. Without a presumption of conflict, we note that one author received grant funding from the AHA. No other relevant conflicts of interest were disclosed.

WHAT ARE THE MAIN RECOMMENDATIONS?

The AHA statement summarizes the adverse effects of elevated blood pressure and the clinical impact of reducing it and offers lifestyle-based and medication-based treatment options. There are 5 take-home points, as follows:

• Stage 1 hypertension is prevalent in outpatient settings and usually progresses to stage 2 hypertension

• Stage 1 hypertension increases the risk for adverse cardiovascular events

• It is possible to blunt or stop the progression of stage 1 hypertension through lifestyle modifications alone

• If lifestyle modifications fail to lower blood pressure in 6 months, pharmacotherapy should be considered for patients with persistent stage 1 hypertension

• The benefits of treating stage 1 hypertension in patients with a low 10-year AS-CVD risk outweigh the risks, given the elevated event rate and common progression to stage 2 hypertension.

The patient population described by the scientific statement is primarily young adults with a low incidence of cardiovascular events, reflecting the fact that age is a major risk factor for cardiovascular disease (CVD).^3,5 Randomized controlled trials powered to detect clinical events are often unfeasible in adults younger than 40 due to the large sample size and long time frame needed to detect events in a lower-risk cohort. Consequently, the AHA recommendations³ reflect observational data on all of the following:

• The significance of hypertension on CVD risk

• Lifestyle therapy to prevent progression of hypertension

• Next steps if lifestyle therapy fails.

SIGNIFICANCE OF LIFETIME RISK FOR CVD AND PROGRESSION OF HYPERTENSION

The prevalence of hypertension increases with age, reaching 82% in US adults age 75 and older.^1,6 Up to 31.6% (95% confidence interval [CI] 27.6%–35.4%) of patients with stage 1 hypertension progress to stage 2 hypertension.⁷ Before the 2017 ACC/AHA clinical practice guidelines were published, observational studies showed a proportional relationship between rising systolic blood pressure and the risk for future CVD events and all-cause mortality.^1,8–10

Patients with stage 1 hypertension as defined by the 2017 ACC/AHA guidelines had an increased incidence of cardiovascular disease (hazard ratio [HR] 1. 75, 95% CI 1.22–2.53) compared with their normotensive counterparts.^3,10 Another study found similar elevations in the risk for cardiovascular disease (HR 1.82, 95% CI 1.12–2.94) and stroke (HR 1.79, 95% CI 1.03–3.11) in patients with stage 1 hypertension compared to normotensive patients.¹¹ Recent multiple studies involving young adults stratified by the revised hypertension definitions further supported this relationship.^10–13 One study that followed Chinese participants over age 35 without CVD for 20 years found that patients with stage 1 hypertension according to the 2017 ACC/AHA guidelines had an increased risk of developing CVD (HR 1.78, 95% CI 1.50–2.11), coronary heart disease (HR 1.77, 95% CI 1.33–2.36), stroke (HR 1.79, 95% CI 1.45–2.22), and CVD mortality (HR 2.50, 95% CI 1.66–3.77) compared with normotensive participants.¹³ There was no relationship between stage 1 hypertension and increased CVD risk in participants over age 60.¹³

Compared with hypertension onset at a later age, hypertension in early adulthood correlates with increased carotid intima-media thickness and coronary artery calcification scores above 100 and confers a significant risk for target-organ damage and premature adverse CVD outcomes. ^14,15

BLUNTING THE PROGRESSION OF HYPERTENSION WITH LIFESTYLE THERAPY

Age-related increases in blood pressure may not be inevitable. Data suggest that low body mass index and adherence to a Dietary Approaches to Stop Hypertension (DASH) diet are associated with a low risk for hypertension over 30 years of follow-up.^1,16,17 Lifestyle modification is the cornerstone of hypertension prevention and treatment.

Although much of the data on lifestyle interventions identifies blood pressure reduction rather than clinical events as the primary end point,^1,17–21 there is a well-established relationship between rising blood pressure and adverse cardiovascular events.^11,12 Evidence-based lifestyle interventions supported by the AHA statement include reducing sodium intake, enhancing potassium intake, decreasing alcohol intake, and increasing physical activity.¹ PREMIER trial (Lifestyle Interventions for Blood Pressure Control)²¹ found significant and sustained blood pressure reductions and less use of hypertensive medications (38% prevalence baseline hypertension vs 12% at 6-month follow-up, P < . 001) in patients randomized to established lifestyle therapy (weight loss, sodium restriction, and increased physical activity) plus the DASH diet. At 18 months, there was a lower prevalence of hypertension and less use of hypertensive medications (38% prevalence baseline hypertension vs 22% at 18-month follow-up, P > .05).²¹ The change in prevalence of hypertension between 6-month and 18-month follow-up could have derived from multiple challenges to maintain adherence to lifestyle therapy, though this was not assessed during the trial.

Blood pressure lowering associated with individual lifestyle changes tends to reduce blood pressure less than medications.³ Because each lifestyle intervention has a modest impact on blood pressure, 2 or more interventions (eg, sodium intake and weight loss) should be targeted.¹⁸ To promote durability in lifestyle modifications, it helps if the patient receives lifestyle counseling by a provider with expertise in behavior change. ^3,22,23

RECOMMENDATIONS WHEN LIFESTYLE THERAPY FAILS

For patients in whom lifestyle modifications do not successfully lower blood pressure below 130/80 mm Hg after 6 months, the AHA statement recommends continued lifestyle interventions and considering treatment with a thiazide diuretic, calcium channel blocker, angiotensin-converting enzyme inhibitor, or angiotensin receptor blocker. The recommendation for pharmacologic intervention applies especially to individuals with a family history of premature CVD, a history of hypertension during pregnancy, or a history of premature birth or premature menopause.^3,24–26 Several randomized trials^27–30 support the AHA emphasis on the effectiveness of pharmacologic interventions (especially with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers) to prevent the progression from what is now classified as stage 1 to stage 2 hypertension.³

WHAT IS DIFFERENT FROM PRIOR GUIDELINES?

These recommendations for early treatment of stage 1 hypertension differ from the prior guidelines with the suggestion of pharmacologic intervention for patients whose blood pressure does not respond to lifestyle modifications. Like the 2017 ACC/AHA hypertension clinical practice guidelines, vigorous implementation of nonpharmacologic or lifestyle therapy remains the initial recommendation for patients with stage 1 hypertension who have an estimated 10-year ASCVD risk of less than 10%. The blood pressure in these patients should be reassessed after 3 to 6 months.¹

DO OTHER SOCIETIES AGREE?

The 2018 Task Force for the management of hypertension published by the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) recommended a systolic blood pressure goal of less than 140 mm Hg.³¹ Blood pressure of 130–139/85–89 mm Hg was considered “high-normal blood pressure,” and antihypertensive medications were not recommended in the absence of very high cardiovascular risk due to established CVD. However, patients with a calculated 10-year ASCVD score of 5% to 10% were considered at high risk. Further, the ESC/ESH guidelines note that antihypertensive drugs may be considered in patients with blood pressure close to the threshold of 140/90 mm Hg after a prolonged attempt to control blood pressure with lifestyle changes, and they suggest that other conditions such as a family history of premature CVD and human immunodeficiency virus infection increase cardiovascular risk. ³¹

HOW WILL THIS CHANGE DAILY PRACTICE?

Patients should be informed that many patients with stage 1 hypertension can lower their blood pressure via intensive lifestyle therapy without the need for medication, but also that medication might be a reasonable option if lifestyle changes do not achieve the desired effect.^17,21 If lifestyle therapy fails to lower blood pressure to less than 130/80 mm Hg, patients and physicians should have some reassurance from trials by Zhang et al³² and by the SPRINT Research Group.³³ These trials demonstrated that targeting a systolic blood pressure goal of less than 130 mm Hg in patients with hypertension who are over age 50 resulted in lower rates of fatal and nonfatal major cardiovascular events and lower all-cause mortality without increasing the risk of adverse events from drug therapy used to achieve a lower blood pressure.^32,33

Given the significant proportion of patients with stage 1 hypertension who progress to stage 2 hypertension and the stepwise increase in cardiovascular risk with each successive stage, we believe that the aggressive treatment of stage 1 hypertension can reduce cardiovascular events.

WHEN WOULD THE GUIDELINES NOT APPLY?

The recommendations provided in the AHA scientific statement apply only to patients in whom lifestyle therapy was not effective at reducing blood pressure to less than 130/80 mm Hg after 6 months. These guidelines do not apply to patients who achieve a blood pressure of under 130/80 mm Hg with 6 months of lifestyle therapy, who are already on antihypertensive medications, or who have secondary causes of hypertension.

THE BOTTOM LINE

The updated AHA position statement is meant to assist clinicians in navigating an important guideline gap in the 2017 ACC/AHA recommendations, ie, the management of patients with stage 1 hypertension and a low 10-year ASCVD risk. The authors of the position statement correctly claim that patients who do not achieve a blood pressure goal of less than 130/80 mm Hg after 6 months of lifestyle therapy should be considered for pharmacologic therapy. However, we believe that clinical judgment should prevail. The ACC/AHA recommendations are population-based and may not apply to individual situations. Both the AHA statement and 2017 ACC/AHA guidelines should serve as a conceptual framework for clinicians, but they do not replace patient-centered conversations between patients and providers.

DISCLOSURES

The authors report no relevant financial relationships which, in the context of their contributions, could be perceived as a potential conflict of interest.

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Understanding the Stages of Hypertension

Doctors classify blood pressure into four categories: normal, prehypertension (mild), stage 1 (moderate) and stage 2 (severe). Treatment depends on which category your pressure consistently falls in when readings are taken. The stages are based on the Joint National Committee 7 report done by the National Heart, Lung and Blood Institute, which is a part of the National Institutes of Health.

Are you doing everything you can to manage your heart condition? Find out with our interactive checkup.

How Blood Pressure is Measured

Blood pressure is measured with an instrument called a sphygmomanometer, through which the user listens for the sound of the force of blood in the patient’s arteries when the heart beats (systolic pressure). Measured in millimeters of mercury (mm Hg), systolic pressure is the top number in your blood pressure reading. The second, or bottom number, is the pressure in the arteries of the heart at rest — the diastolic pressure. Generally, as an adult, you are considered to have high blood pressure if your systolic pressure reading is greater than or equal to 140 mm Hg or if your diastolic pressure is greater than or equal to 90 mm Hg. But for every 20 mm Hg your systolic pressure raises above 115, and for every 10 mm Hg your diastolic pressure rises over 75, your risk of cardiovascular disease doubles — so lower pressures are generally better.

Stages of Hypertension

Here’s a look at the current stages and their recommended treatments:

• Normal. Systolic less than 120 mm Hg and diastolic less than 80 mm Hg. No treatment is necessary, but you should monitor your blood pressure to be sure that it remains within the normal range.
• Prehypertension: Systolic between 120 and 139 mm Hg or a diastolic between 80 and 89 mm Hg. “Prehypertension designates just what the term sounds like,” says Daniel Jones, MD, dean of the school of medicine at the University of Mississippi Medical Center in Jackson, Miss., and past president of the American Heart Association.. “It’s before someone crosses the threshold for the definition of hypertension but is at risk for developing hypertension. We don’t have evidence that using medications at this range is useful for preventing heart disease and stroke. However, because people in this group have some risk of moving on to developing heart disease, we recommend lifestyle measures to try to prevent the onset of hypertension.” Lifestyle measures include exercise, managing body weight into a normal range, eating a diet high in fruits and vegetables, and choosing low-fat dairy products.
• Stage 1: Systolic between 140 and 159 mm Hg or diastolic 90 and 99 mm Hg. Management includes the same lifestyle measures as with prehypertension and the use of one of a number of drugs that are known to not only reduce blood pressure but also to reduce the risk of heart disease and stroke. Classes of drugs include: thiazide diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, and calcium channel blockers. You may have to try different drugs until you find the one that has the best results for you. If you are African-American, you may be at higher than average risk for complications from hypertension. The JNC guidelines recommend that African Americans start with a regimen of two drugs if their top blood pressure reading is 145 mm Hg or higher.
• Stage 2: Systolic 160 mm Hg or higher or diastolic 100 mm Hg or higher. In addition to lifestyle changes, “for many patients, it’s recommended that a two-drug therapy chosen from among the five classes of hypertensive agents be used to get their blood pressure down,” Dr. Jones says. “Again, you may have to experiment some to determine which combination of drugs works best for your body.

If your systolic and diastolic pressures fall into different stages, the stage with the higher number is the one that counts. For example, if you have a systolic pressure of 150 mm Hg but your diastolic pressure is only 85 mm Hg, you will be classified as stage 1 hypertension, not prehypertension. And if you are over age 50, it is the diastolic number that best predicts your risk of cardiovascular disease.

Left untreated, high blood pressure can lead to coronary heart disease, which can mean a heart attack or stroke. You should have your blood pressure checked regularly, and follow your doctor’s advice for keeping it under control.

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Hypertension – description, treatment, prevention

Hypertension, its symptoms and prevention

Hypertension is a very common disease, especially among people over 40 years of age. It occurs on average in 10-20% of the adult population. If you lead a wrong lifestyle and ignore the first signs of the disease, then it begins to progress.

What is hypertension

m arterial pressure (BP) caused by disruption of the heart and regulation of vascular tone and not associated with diseases of the internal organs. Hypertension should not be confused with a symptomatic increase in blood pressure when it is a symptom of a certain disease (endocrine system disease, kidney disease, etc.).

The World Health Organization (WHO) has determined the upper limit of blood pressure, which can be considered normal – 140/90 mmHg. Pressure exceeding these figures is considered elevated.

Hypertension can accelerate the development of atherosclerosis and coronary heart disease.

Symptoms of hypertension

In some people, hypertension has a long asymptomatic period. Most often, the signs of the disease appear during hypertensive crises, that is, a sharp jump in blood pressure. Then patients feel headache, dizziness, chest pain, shortness of breath and a feeling of fear.

Most people feel heaviness in the back of the head, fatigue, flickering before the eyes when pressure increases. Nausea, dizziness, and nosebleeds sometimes occur, which can relieve headaches. With long-term hypertension, shortness of breath and angina pectoris, an increase in the left ventricle, as well as visual impairment and impaired renal function are possible.

Both in patients and in healthy people, blood pressure changes during the day. It usually reaches its minimum at night, at rest, between 11 p.m. and 3 a.m. (basal pressure), and its maximum in the late afternoon, from 5 p.m. to 8 p.m. Daytime blood pressure varies depending on physical activity, emotional state, ambient temperature and other factors. Therefore, for the diagnosis of hypertension, it is most effective to use the method of daily monitoring.

Classification of hypertension 011 Hypertension is classified according to the degree of increase in blood pressure:

• 1 degree – 140-159 / 90-99 mmHg;
• 2 degree – 160-179 / 100-109 mmHg;
• 3 degree – above 180/100 mmHg.

There are several stages in the development of hypertension:

• Stage 1 – minor and intermittent changes in blood pressure, without violations of the functions of the cardiovascular system;
• Stage 2 – permanent changes in blood pressure, accompanied by hypertrophy of the left ventricle, but without other organic changes;
• Stage 3 – persistent high blood pressure with changes in the heart (coronary heart disease, heart failure), brain and kidneys.

Causes of hypertension

90 011 The risk group for increased blood pressure includes, first of all, middle-aged and elderly people: men after 40 years and women after 50 years, and as well as diabetic patients. It is assumed that heredity plays an important role in the development of hypertension.

In addition, factors contributing to the development of hypertension include:

• smoking;
• alcohol abuse;
• overeating and obesity;
• elevated blood cholesterol;
• severe emotional stress;
• hypodynamia (low physical activity).

Treatment and prevention of hypertension

to normal? Because the longer the vessels are under high pressure, the faster irreversible changes occur in their walls. The walls of the arteries thicken and lose elasticity, the lumen of the vessel is significantly reduced. With hypertension, all vessels undergo such changes, there is a “hypertensive heart”, “hypertensive kidney”, hypertensive angiopathy of the retinal vessels and other similar manifestations of the disease.

Treatment of hypertension must be comprehensive, individually selected and aimed at normalizing blood pressure and maintaining it at an optimal level. Sanatorium-and-spa treatment of hypertension is an extremely important part of the medical complex, and especially in the early stages of the disease.

Hypertension: stages 1 and 2 and risk 3

Contents

• 1 Hypertension: stages, risks and home treatment
  • 1. 1 Hypertension: what it is
    • 1.1.1 Definition
    • 1.1.2 Causes
    • 1.1.3 Symptoms
    • 1.1.4 Treatment
    • 1.1.5 Risk 3 9 0076
  • 1.2 Definition and summary of essential hypertension
    • 1.2.1 Definition:
    • 1.2.2 Characterization:
  • 1.3 Stages and risk of developing hypertension
    • 1.3.1 Stages
    • 1.3.2 Risk 90 076
  • 1.4 Hypertension stage 1 stage 2 risk 3: Description of stage 1
    • 1.4.1 What is stage 1 hypertension?
    • 1.4.2 What are the symptoms of stage 1 hypertension?
    • 1.4.3 How is stage 1 hypertension defined?
    • 1.4.4 What are the possible consequences of not treating stage 1 hypertension?
  • 1.5 Hypertension stage 1 stage 2 risk 3: Description stage 2
    • 1.5.1 What is stage 2 hypertension?
    • 1.5.2 Symptoms of hypertension stage 2
    • 1.5.3 Treatment of stage 2 hypertension
    • 1.5.4 Prognosis of stage 2 hypertension
  • 1. 6 Risk of stage 3 hypertension
  • 1.7 Symptoms of hypertension
    • 1. 7.1 High blood pressure
    • 1.7.2 Headache and dizziness
    • 1.7.3 Throbbing sensation in the head and neck
    • 1.7.4 Shortness of breath and feeling tired
    • 1.7.5 Palpitations and possible heart rhythm disturbances
  • 1.8 How can I detect hypertension?
  • 1.9 Manifestation of hypertension stage 1 or 2 risk 3: main symptoms
    • 1.9.1 Sleep and memory disorders
    • 1.9.2 Headache and dizziness
    • 1.9.3 Vision and tinnitus

    90 075 1.9.4 Enhanced blood pressure

  • 1.10 Treatment of hypertension
    • 1.10.1 Drug therapy
    • 1.10.2 Lifestyle and diet
    • 1.10.3 Control of blood pressure
  • 1.11 Non-drug treatments for hypertension
    • 1.11.1 Proper nutrition
    • 1.11.2 Exercise
    • 1.11.3 Avoiding bad habits

    9007 5 1.11.4 Stress management

  • 1. 12 Drug treatment of hypertension Stage 1 Stage 2 risk 3
    • 1.12.1 Principles of drug treatment
    • 1.12.2 Prescribing and monitoring drug treatment
  • 1.13 Related videos:
  • 1.14 Q&A:
    • • 1.14.0.1 What is hypertension?
      • 1.14.0.2 What are the symptoms of hypertension stage 2 risk 3?
      • 1.14.0.3 How is hypertension diagnosed?
      • 1.14.0.4 What are the causes of hypertension?
      • 1.14.0.5 How is hypertension stage 1 risk 3 treated?
      • 1.14.0.6 What are the consequences of stage 2 risk 3 hypertension?

Learn all about hypertension stage 1 and 2 and risk 3. What are the symptoms, causes and treatment? Read on our website!

Hypertension is a common disease among the inhabitants of the country. It can lead to serious complications if you do not consult a doctor in time. The main cause of this disease is an increase in blood pressure, which can disrupt the function of the heart and blood vessels.
Hypertension refers to chronic diseases and is classified into several degrees depending on the level of increase in blood pressure. In modern medicine, there are three degrees of hypertension and several stages of risk.
In this article, we will look at the first and second stages of hypertension, as well as the third stages of risk, to help people who are faced with this disease to better understand its features and take the right measures to treat and prevent possible complications.

Hypertension: what it is

Definition

Hypertension (arterial hypertension) is a chronic disease in which blood pressure is constantly elevated to a level above 140/90 mmHg Art.

Causes

Hypertension can occur due to various factors such as obesity, lack of physical activity, malnutrition, stress and genetic predisposition.

Symptoms

In the early stages, the disease may not show bright manifestations, but later headaches, dizziness, tinnitus, blurred vision, fatigue and neuralgia may occur.

Treatment

Treatment for hypertension includes medication, regular blood pressure monitoring, and lifestyle changes that include proper nutrition, moderate physical activity, and stress avoidance.

Risk 3

Hypertension stage 1 or stage 2 risk 3 means that the patient is at high risk for complications associated with the disease, such as heart attack, stroke, and organ damage.

Definition and brief characteristics of hypertension

Definition:

Hypertension (AH) is a chronic disease characterized by persistently elevated blood pressure (BP) above normal. In most cases, patients do not pay attention to the increasing pressure, but over time this leads to serious complications.

Feature:

As a rule, hypertension lasts for a long time, without symptoms or little noticeable symptoms, but gradually and steadily increases the level of blood pressure. According to the modern classification, hypertension can be divided into several stages depending on the height of pressure and the presence of complications. The stages of hypertension are determined on the basis of an analysis of the level of blood pressure and additional studies, such as measuring glucose and cholesterol in the blood, ECG and ultrasound examination of organs.

• Stage 1: BP 140-159 / 90-99 mmHg without complications.
• Stage 2: BP 160-179 / 100-109 mmHg with complications.
• Stage 3: BP from 180 / 110 mmHg. with serious complications.

Hypertension is one of the main risk factors for the development of cardiovascular diseases such as stroke, myocardial infarction, circulatory disorders in the kidneys and eyes, vascular dysfunction and aneurysms. Fortunately, hypertension can be successfully managed with modern medications, a healthy lifestyle, and BP control.

Stages and risk of developing hypertension

Stages

Hypertension is a disease that develops in stages. There are several stages of hypertension. At the first stage, blood pressure rises to a value of 140/90 mm Hg. In the second stage, the pressure is above 160/100 mm Hg. At the third stage, the pressure reaches 180/110 mm Hg. At each subsequent stage of hypertension, the risk of serious complications increases.

Risk

One of the indicators of hypertension is the risk of developing cardiovascular complications. The risk depends on several factors – the stage of hypertension, age, the presence of other diseases, lifestyle and heredity.

It is important to remember that hypertension requires constant monitoring and treatment, even if the risk of complications is currently low. Irregular treatment can lead to the development of serious complications that can be life threatening.

Stage 1 hypertension Stage 2 risk 3: Stage 1 description

What is stage 1 hypertension?

Stage 1 hypertension is the initial stage of high blood pressure when the values ​​do not exceed 140/90 mmHg But even at this stage, changes in the body are already taking place, which in the long run can lead to serious health problems.

What are the symptoms of stage 1 hypertension?

At this stage of hypertension, there may be no symptoms, but sometimes patients may complain of: headaches, fatigue, dizziness, palpitations and sleep disturbances.

How is stage 1 hypertension diagnosed?

For the diagnosis of stage 1 hypertension, repeated blood pressure measurements are used over several weeks. Normal blood pressure is repeated twice at different times of the day while monitoring pressure throughout the day. A slight increase in blood cholesterol levels may also be found.

What are the possible consequences of not treating stage 1 hypertension?

Although symptoms may be mild at this stage, if left untreated, complications can result, such as damage to organs, including the heart, brain, and kidneys. Therefore, it is important to detect and treat stage 1 hypertension in a timely manner to prevent serious consequences.

Hypertension stage 1 stage 2 risk 3: Description stage 2

What is stage 2 hypertension?

Stage 2 hypertension is a serious condition in which blood pressure rises to 160-179 mmHg. (systolic) and / or up to 100-109 mm Hg. (diastolic). At the same time, the work of many body systems is disrupted, and the risk of complications increases.

Symptoms of hypertension stage 2

Symptoms of hypertension stage 2 can manifest themselves in a variety of ways. These may include headaches, dizziness, tinnitus, fatigue, decreased performance, poor sleep, and visual disturbances. Some people may not experience any symptoms but still have high blood pressure.

Treatment of stage 2 hypertension

Treatment of stage 2 hypertension should begin with lifestyle and dietary changes. Patients should stop smoking, drinking large doses of alcohol, begin to engage in physical activity, and control their weight. In addition, drug therapy may be prescribed – drugs that lower blood pressure and protect against complications. Treatment should be carried out under the supervision of a doctor who determines an individual approach and chooses the most effective methods.

Prognosis of stage 2 hypertension

The prognosis of stage 2 hypertension depends on many factors – the magnitude of pressure, the presence of concomitant diseases, the age and lifestyle of the patient. If the disease is detected at an early stage, and the patient follows the recommendations of the doctor, then the prognosis may be favorable. However, without control and proper treatment, stage 2 hypertension can lead to serious complications such as heart attack, stroke, and problems with the functioning of the cardiovascular system.

Stage 3 hypertension risk

Hypertension is a chronic disease that can lead to serious health consequences such as stroke, heart attack and kidney disease. With the development of hypertension, three stages of the disease often occur, and the risk of developing stage 3 hypertension is the most dangerous.

It is important to remember that the risk of developing stage 3 hypertension can be reduced with regular monitoring of blood pressure, proper treatment, healthy lifestyles, and changes in habits that can lead to high blood pressure.

1. Reduced dietary intake of salt and animal fats;
2. Increased consumption of fruits, vegetables and green foods;
3. Smoking cessation;
4. Moderate physical activity;
5. Timely treatment of other diseases that contribute to the development of hypertension (diabetes, obesity, metabolic disorders).

Thus, the risk of developing stage 3 hypertension can be reduced with improved blood pressure control, timely medical attention, proper treatment, and changing habits that promote a healthy lifestyle.

Symptoms of hypertension

High blood pressure

The most important symptom of hypertension is constantly high blood pressure. It can be detected by measuring pressure with a tonometer and must be controlled.

Headache and dizziness

One of the most common symptoms of hypertension is headache, which can occur in the neck, forehead and temples. Dizziness is also common, especially when changing body position or after physical exertion.

Pulsating sensation in the head and neck

Pulsating sensation in the head and neck may also be a symptom of hypertension. The sensation of pulsation may be due to an overreaction to an increase in blood pressure.

Shortness of breath and feeling tired

In hypertension, shortness of breath may occur, which manifests itself during physical exertion or even at rest. It is also possible to feel tired and weak, which can be caused by a decrease in the quality of sleep or a metabolic disorder.

Palpitations and possible heart rhythm disturbances

Possible heart palpitations, as well as heart rhythm disturbances such as extrasystoles and atrial fibrillation. They can be caused by excessive excitations of the nervous system or myocardial ischemia.

How to determine the presence of hypertension?

Hypertension is common among people over 40 years of age. Signs of hypertension can vary, so it is important to know which symptoms may indicate the development of this disease.

• Constant increase in blood pressure. Here it is important to know your blood pressure standards and monitor its performance.
• Headaches, often localized in the occipital region.
• Dizziness, feeling of weakness and fatigue.
• Pain in the heart (chest), interruptions in the heart.
• Edema of the lower extremities, morning swelling of the face.

If you suspect that you have hypertension, be sure to consult your doctor. It is important to remember that early diagnosis and treatment of hypertension helps to avoid serious complications of the disease and maintain health.

In addition to a visit to the doctor, blood pressure measurements at home with a tonometer and monitoring of diet and lifestyle can be signs of hypertension. It is important to give up bad habits, monitor weight and physical activity, and maintain a healthy daily routine.

Manifestation of hypertension stage 1 or 2 risk 3: main symptoms

Sleep and memory disorders

One of the first symptoms of hypertension is sleep disturbance, which can manifest itself as insomnia or drowsiness during the day. There may also be problems with memory, concentration and orientation in space.

Headache and dizziness

Patients with hypertension may often complain of headache, which can be severe and prolonged. Dizziness may also be present, especially with changes in body position.

Vision and tinnitus

Hypertensive patients may experience visual disturbances such as dilated pupils, diplopia or redness of the eyeballs. Often, patients also complain of tinnitus, which occurs due to circulatory disorders in the vessels of the brain.

High blood pressure

And, of course, one of the main symptoms of hypertension is a constant increase in blood pressure, which can reach very high levels. This symptom requires immediate intervention and treatment.

If you experience any of these symptoms, please see your doctor. Hypertension is not able to be cured by itself and requires complex treatment and constant monitoring by specialists.

Treatment of hypertension

Drug therapy

There are many drugs for the treatment of hypertension, but the choice of a particular drug depends on the degree of hypertension, the presence of comorbidities and the individual patient. Usually, one drug is given to start treatment and then others are added as needed. Treatment should only be carried out under the supervision of a physician, as too high a dosage can be harmful to health.

Drugs used in hypertension may include angiotensin-converting enzyme inhibitors, beta-blockers, diuretics, calcium antagonists, renin-angiotensin-aldosterone inhibitors, and others.

Life style and diet

In addition to medication, it is important to take care of your overall health. It is necessary to monitor your weight, do not smoke, limit alcohol consumption and exercise regularly. In addition, you should monitor your diet: eat less salt, limit the intake of fatty and fried foods, increase the amount of fruits, vegetables and grains in the diet.

In addition, it is recommended to include in the diet foods that help lower blood pressure, such as watermelons, cherries, low-sugar chocolate, nuts, and some spices.

Blood pressure monitoring

To control your blood pressure, it is recommended that you measure your blood pressure regularly at home and record the results. This will help to monitor the effectiveness of treatment and take timely measures in case of deterioration. It is also important to regularly visit a doctor and undergo the necessary examinations.

In hypertension stage 1 and 2, risk 3, it is important not to delay treatment, as this can lead to serious consequences. With the right drug therapy and lifestyle changes, most patients successfully control their condition.

Non-drug treatments for hypertension

Proper nutrition

Proper nutrition is one of the key methods of non-drug therapy for hypertension. Vegetables, fruits, cereals, fish, low-fat meats, low-fat dairy products are recommended. It is important to reduce your intake of salt, fatty meats, sugar, and foods high in cholesterol. In addition, potassium-rich foods such as beans, nuts, potatoes, and bananas are helpful.

Exercise

Regular exercise such as walking, swimming, cycling, yoga helps improve blood circulation, reduce weight and lower blood pressure. Before starting classes, it is recommended to consult a doctor and start with a gradual increase in load.

Quit bad habits

Some bad habits, such as drinking alcohol and smoking, can increase your risk of developing hypertension and make it more difficult. Therefore, it is recommended to abandon these habits and lead a healthy lifestyle.

Stress control

Stress can lead to high blood pressure, so it is important to learn how to control your emotional state. To do this, you can use various methods, such as meditation, yoga, deep breathing, massage and other relaxation techniques.

Drug treatment of hypertension stage 1 stage 2 risk 3

Principles of drug treatment

Treatment of hypertension stage 1 stage 2 risk 3 is a long process and includes medication, diet, regular physical activity and blood pressure control.

The main principle of drug treatment is to reduce blood pressure to target values: less than 130/80 mm Hg. Art. for many patients and less than 120/70 mm Hg. Art. for some.

Various classes of antihypertensive drugs are used to treat hypertension stage 1 stage 2 risk 3: thiazide diuretics, ACE inhibitors, AT1 receptor blockers, and others. The choice of drugs depends on the individual characteristics of the patient and concomitant diseases.

Prescribing and monitoring drug treatment

Drug treatment is prescribed by a doctor and is selected individually for each patient. When prescribing medicines, the doctor takes into account age, gender, weight, the presence of concomitant diseases and other factors.

It is important to remember that discontinuation of the medication may have the opposite effect and worsen the patient’s health. You should always strictly follow the doctor’s recommendations and do not change the dosage or regimen of medication on your own.

Related videos:

Q&A:

What is hypertension?

Hypertension is a disorder of blood pressure, in which it is elevated for a long time. This is due to disorders of the heart and blood vessels.

What are the symptoms of hypertension stage 2 risk 3?

Symptoms of stage 2 risk 3 hypertension may include headaches, dizziness, tinnitus, palpitations, sweating, headache, fatigue. However, in many cases this stage of the disease is asymptomatic.

How is hypertension diagnosed?

Blood pressure must be measured to diagnose hypertension. Additional tests, such as ECG, echocardiography, blood and urine tests, may be done to confirm the diagnosis.

What are the causes of hypertension?

Hypertension can be associated with many factors, such as heredity, age, bad habits, poor diet, lack of physical activity, metabolic disorders, etc.

How is hypertension stage 1 risk 3 treated?

Treatment of hypertension includes lifestyle changes (eliminating bad habits, proper nutrition, physical activity), the use of drugs to reduce pressure and control its indicators.