Hypertension (High Blood Pressure): High-Yield Notes

Often silent → needs regular BP checks → long-term damage to heart, brain, kidneys, eyes

Key Points

• Most people have NO symptoms
• Headache/dizziness can occur but are non-specific
• Nosebleeds are rare and not a reliable sign

BP Categories (ACC/AHA, office readings)

• Normal: <120 / <80
• Elevated: 120–129 / <80
• Stage 1: 130–139 or 80–89
• Stage 2: ≥140 or ≥90

Diagnosis needs repeat readings (home/ambulatory preferred if available)

Possible Symptoms (Usually when high/severe or complications)

• Headache (sometimes)
• Dizziness/lightheadedness (sometimes)
• Chest discomfort/shortness of breath (if severe or heart disease)

Long-term Complications (Target-organ damage)

• Heart: LVH, CAD/MI, heart failure
• Brain: stroke/TIA, vascular dementia
• Kidneys: CKD, proteinuria
• Eyes: hypertensive retinopathy/vision loss

Go to ER NOW (Hypertensive emergency red flags)

• BP ≥180/120 + symptoms
• Severe chest pain
• Severe shortness of breath
• Severe headache + confusion
• Weakness/numbness on one side or trouble speaking (stroke signs)
• Vision loss

Management (High-yield)

• Lifestyle:
• weight loss,
• DASH diet,
• salt,
• exercise,
• limit alcohol,
• stop smoking

Meds (common first-line): thiazide, ACEi/ARB, CCB (choice depends on patient)

• Check for secondary causes if young/severe/resistant (renal disease, endocrine causes, OSA)

Exam Tip

• Stage 2 HTN or HTN with diabetes/CKD/CVD risk → usually needs meds + lifestyle (not lifestyle alone).

From: Paul S.Dangha.BSc Microbiology, MLT (AMT),PT(ASCP).