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Hypertension, Essential

Ronald N. Adler, FAAFP, MD and Jeremy Golding, FAAFP, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Essential hypertension (HTN) is HTN without an identifiable cause; also known as primary HTN and (inappropriately) as benign HTN. Although its importance as a risk factor for cardiov...

DIAGNOSIS

  • Despite more aggressive guidelines issued by the ACC/AHA in 2017, many experts consider recommendations from JNC 8 (1)  to retain primacy.

  • Critics of the ACC/AHA guidelines note multiple met...

TREATMENT

GENERAL MEASURES

  • The treatment discussed follows JNC 8 guidelines. Recent systematic reviews and meta-analyses of randomized trials do not support recommendations for lower-than-standard targ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

ALERT

Repeat electrolytes, BUN/creatinine about 3 to 6 weeks after initiating thiazide diuretics, ARB, or ACEi, to evaluate for drug-induced comp...

REFERENCES

1
James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint Nationa...

SEE ALSO

Hypertension, Secondary and Resistant; Hypertensive Emergencies; Polycystic Kidney Disease 

CODES

ICD10

I10 Essential (primary) hypertension 

SNOMED

  • 59621000 Essential hypertension (disorder)

  • 1201005 Benign essential hypertension

CLINICAL PEARLS

  • Treatment of HTN reduces risk of major adverse CV events (MACE). The NNT to prevent a MACE from 10 to 50 per year in patients with severe HTN, but hundreds or thousands per year for pa...

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