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p. 131

A diagnosis of hypertension is based on the mean of two or more

properly measured seated blood pressure (BP) measurements taken on

two or more occasions.

Case 9-1 (Questions 1, 2),

Table 9-1, Table 9-4, Figure

9-1

Most patients with hypertension have a recommended BP goal of less

than 140/90 mm Hg (including those with diabetes or chronic kidney

disease [CKD] under age 70 years). Elderly patients (age > 60 years)

have a higher BP goal of less than 150/90 mm Hg (see core principle

#7).

Case 9-1 (Questions 6, 7, 8),

Figure 9-2

Lifestyle modifications are the foundation for preventing hypertension,

and they are an important component of first-line therapy in all patients

treated with antihypertensive drug therapy.

Case 9-1 (Questions 11, 12,

13),

Table 9-5

Evidence supports the use of an angiotensin-converting enzyme inhibitor

(ACEI), angiotensin receptor blocker (ARB), calcium-channel blocker

(CCB), or thiazide diuretic as first-line therapy to prevent cardiovascular

(CV) events for most patients.

Case 9-1 (Questions 9, 14,

15),

Case 9-3 (Question 2),

Case 9-4 (Questions 1-9),

Case 9-6 (Questions 1-3 and

6-10),

Figure 9-2, Table 9-8, Table

9-9, Table 9-11, Table 9-12,

Table 9-13

In black population, including those with diabetes, evidence supports the

use of thiazide diuretics and CCB.

Case 9-1 (Questions 16, 17),

Case 9-5 (Question 1)

Case 9-6 (Question 4)

Pharmacotherapy recommendations for patients with hypertension and

other comorbidities are specifically based on evidence demonstrating

reduced risk of CV events.

Case 9-1 (Question 10),

Case 9-3 (Questions 2, 4)

Case 9-7 (Question 2), Table

9-7

Elderly patients with hypertension should be managed using the same

general treatment principles that apply to all patients with hypertension.

However, their BP goal is higher (less than 150/90 mm Hg) unless they

also have CKD and age younger than 70 years. In such case, their BP

goal is less than 140/90 mm Hg.

Case 9-2 (Questions 1, 2)

In the population aged ≥18 years with CKD and age under 70 years,

evidence supports initial (or add-on) antihypertensive treatment to

include an ACEI or ARB to improve renal outcomes. This applies to all

CKD patients with hypertension regardless of race or diabetes status.

Case 9-3 (Questions 1, 3),

Case 9-6 (Question 5)

If goal BP is not attained within a month of treatment, increase the dose

of the initial drug or add a second drug (ACEI, ARB, CCB, or thiazide

diuretic). If goal BP cannot be reached with two drugs, add and titrate a

third drug. If goal BP cannot be reached using only the drugs

recommended as first line, because of a contraindication or the need to

use more than three drugs to reach goal BP, antihypertensive drugs

from other classes can be used. Referral to a hypertension specialist

may be indicated.

Case 9-4 (Question 10),

Case 9-5 (Question 1)

Case 9-8 (Questions 1–3)

Case 9-9 (Questions 1–4)

Case 9-10 (Questions 1–3)

Case 9-11 (Questions 1–4)

Case 9-12 (Questions 1–4)

Table 9-2, Table 9-3, Table

9-10, Table 9-14, Table 9-15

p. 132

p. 133

INTRODUCTION

Approximately 80 million Americans have hypertension, also called high blood

pressure (BP).

1

It is estimated that approximately 33% of adult Americans have

hypertension, making it the most frequently encountered chronic medical condition.

About 77% of those are using antihypertensive medication, but only 54% of those are

controlled (defined as both systolic BP [SBP] <140 mm Hg and diastolic BP [DBP]

<90 mm Hg). It is also one of the most significant risk factors for cardiovascular

(CV) morbidity and mortality resulting from target-organ damage to blood vessels in

the heart, brain, kidney, and eyes. These complications can manifest as either

atherosclerotic vascular disease or other forms of CV disease. The exact etiology of

essential hypertension is unknown; however, lifelong management with lifestyle

modifications and pharmacotherapy are usually needed.

Blood Pressure

During systole, the left ventricle contracts, ejecting blood systemically into the

arteries causing a sharp rise in arterial BP. This is the systolic BP. The left ventricle

then relaxes during diastole, and arterial BP decreases to a trough value as blood

returns to the heart from the venous system. This is the diastolic BP. When recording

BP (e.g., 120/76 mm Hg), the numerator is the SBP and the denominator is the DBP.

BP has a predictable diurnal rhythm, with fluctuations throughout the day. Values are

lowest during the nighttime, sharply rise starting in the early morning, and peak in the

late morning to early afternoon.

Mean arterial pressure (MAP) is sometimes used to represent BP, especially in

patients with hypertensive emergency. MAP collectively reflects both SBP and DBP,

with one-third of the pressure from SBP and two-thirds from DBP. It is calculated

using the following equation (Eq. 9-1):

Hypertension is defined as an elevated SBP, DBP, or both. A clinical diagnosis of

hypertension is based on the mean of two or more properly measured seated BP

measurements taken on two or more occasions. Since 1976, the National Heart Lung

and Blood Institute has collaborated with researchers and practitioners to develop

clinical practice guidelines focused on the management of hypertension (The Joint

National Commission [JNC]). In late 2013, the eighth edition of the JNC guidelines

were released.

2 Unlike previous editions of the JNC guidelines, definitions and

staging of BP were not addressed, but thresholds for pharmacologic treatment were

defined, which will be discussed here.

PATHOPHYSIOLOGY OF BLOOD PRESSURE REGULATION

Various neural and humoral factors are known to influence and regulate BP.

3 These

include the adrenergic nervous system (controls α- and β-adrenergic receptors), the

renin–angiotensin–aldosterone system (RAAS) (regulates systemic and renal blood

flow), renal function and renal blood flow (influences fluid and electrolyte balance),

several hormonal factors (adrenal cortical hormones, vasopressin, thyroid hormone,

and insulin), and the vascular endothelium (regulates release of nitric oxide [NO],

bradykinin, prostacyclin, and endothelin). Knowledge of these mechanisms is

important in understanding antihypertensive drug therapy. BP is normally regulated

by compensatory mechanisms that respond to changes in cardiac demand. An

increase in cardiac output (CO) normally results in a compensatory decrease in total

peripheral resistance (TPR); likewise, an increase in TPR results in a decrease in

CO. These events regulate MAP, as is represented in the following equation (Eq. 9-

2):

Adverse changes in BP can occur when these compensatory mechanisms are not

functioning properly. It has been suggested that in hypertension an initial increase in

fluid volume increases CO and arterial pressure. Eventually, with long-standing

hypertension, it is believed that TPR increases so that CO returns to normal.

The kidney plays an important role in the regulation of arterial pressure, especially

through the RAAS. Decreases in BP and renal blood flow, volume depletion or

decreased sodium concentration, and an activation of the sympathetic nervous system

can all trigger an increased secretion of the enzyme renin from the cells of the

juxtaglomerular apparatus in the kidney. Renin acts on angiotensinogen to catalyze the

formation of angiotensin I. Angiotensin-converting enzyme (ACE) converts

angiotensin I to angiotensin II (see Figs. 14-2 and 14-6 in Chapter 14, Heart Failure).

Angiotensin II is a potent vasoconstrictor that acts directly on arteriolar smooth

muscle and also stimulates the production of aldosterone by the adrenal glands.

Aldosterone causes sodium and water retention and the excretion of potassium.

Several factors influence renin release, especially those that alter renal perfusion.

The resultant increase in BP results in suppression of renin release through negative

feedback.

Approximately 20% of patients with essential hypertension have lower-thannormal plasma renin activity (PRA), whereas approximately 15% have PRA

concentrations that are higher than normal. Those with normal to high PRA (e.g.,

young and whites) should theoretically be more responsive to drug therapies that

target the RAAS (e.g., ACE inhibitors and angiotensin receptor blockers [ARBs]).

Patients with low PRA may be more responsive to diuretic therapy. However,

routinely measuring PRA as a strategy to guide empiric drug selection has limited

clinical utility and does not generally result in an outcome superior to careful

selection of antihypertensive drug therapy.

Arterial BP is also regulated by the adrenergic nervous system, which causes

contraction and relaxation of vascular smooth muscle. Stimulation of α-adrenergic

receptors in the central nervous system (CNS) results in a reflex decrease in

sympathetic outflow, causing a decrease in BP. Stimulation of postsynaptic α1

-

receptors in the periphery causes vasoconstriction. The α-receptors are regulated by

a negative feedback system; as norepinephrine is released into the synaptic cleft and

stimulates presynaptic α2

-receptors, further norepinephrine release is inhibited. This

negative feedback results in a balance between vasoconstriction and vasodilatation.

Stimulation of postsynaptic β1

-receptors located in the myocardium causes an

increase in heart rate and contractility, whereas stimulation of postsynaptic β2

-

receptors in blood vessels results in vasodilation.

A direct association exists between sodium and BP. Although there is a

considerably high degree of patient variability in BP sensitivity to sodium (likely

affected by heredity and interactions with other environmental exposures), patients

with a high dietary sodium intake generally have a greater prevalence of hypertension

than those with a low sodium intake. The mechanism by which excess sodium intake

contributes to hypertension is uncertain, but it is believed to involve an undetermined

natriuretic hormone (not the A- and B-type natriuretic peptides associated with heart

failure) that may be induced as a consequence of impaired renal sodium excretion.

This natriuretic hormone might also cause an increase in intracellular sodium and

calcium, resulting in increased vascular tone and hypertension. The consequences of

impaired sodium excretion may have an underlying evolutionary basis. Human

physiology evolved in a “hunter-gatherer” society with diets characterized by low

sodium and high potassium. The

p. 133

p. 134

relatively recent shifts in diet patterns brought about by the advent of modern food

processing, coupled with increased survival beyond reproductive years, may not

have made it possible for modern humans to adapt successfully to high sodium

exposure.

Epidemiologic evidence and clinical trials have demonstrated an inverse

relationship between calcium and BP. One proposed mechanism for this relationship

involves an alteration in the balance between intracellular and extracellular calcium.

Increased intracellular calcium concentrations can increase peripheral vascular

resistance (PVR), resulting in increased BP.

A decrease in dietary potassium has been associated with an increase in PVR. In

theory, diuretic-induced hypokalemia could counteract some of the antihypertensive

effects of diuretic therapy, but this has not been seen in clinical trials. It is important,

however, that potassium concentrations be maintained within the normal range

because hypokalemia increases the risk of CV events, such as sudden death.

Insulin resistance and hyperinsulinemia also have been associated with

hypertension. Kaplan

3 suggests that insulin resistance is responsible for the frequent

coexistence of hyperglycemia, dyslipidemia, hypertension, and abdominal obesity

(also called the metabolic syndrome).

4 The exact role of insulin resistance in the

development of hypertension is still evolving.

The vascular epithelium is a dynamic system in which vascular tone is regulated

by numerous substances. As noted previously, angiotensin II promotes

vasoconstriction of the vascular epithelium. However, several other substances

regulate vascular tone. NO is produced in the endothelium and is a potent

vasodilatory chemical that relaxes the vascular smooth muscle. Hypothetically, some

patients with hypertension have an intrinsic deficiency in NO release and inadequate

vasodilation, which could contribute to hypertension and its vascular complications.

Factors that regulate BP are well understood and continue to evolve, but the cause

of essential hypertension is still unknown. It is impossible to target therapy to

specific abnormalities. Therefore, antihypertensive therapy should be selected based

on evidence from clinical trials that have demonstrated reductions in hypertensionassociated complications, as is discussed later in this chapter.

CARDIOVASCULAR RISK AND BLOOD PRESSURE

Direct correlations between BP values and risk of CV disease have been established

based primarily on epidemiologic data. Beginning at a benchmark BP of 115/75 mm

Hg, the risk of CV disease doubles with every increment of 20/10 mm Hg.

4

Clinically, it is important to note that incremental elevations in SBP are more

predictive of CV disease than elevations in DBP, especially for patients older than

50 years of age. Therefore, SBP is the target of evaluation and intervention for most

patients with hypertension. In younger patients with hypertension, elevated DBP may

be the only BP abnormality present.

1.

2.

3.

4.

5.

6.

7.

MEASURING BLOOD PRESSURE

Auscultatory Method

The measurement of BP should be standardized to minimize variability in readings.

The American Heart Association (AHA) technique for auscultatory BP measurement

(Table 9-1)

5 should be used in most patients.

6

For a video demonstrating methods for measuring BP in adults (courtesy of the University of Colorado

School of Pharmacy), go to http://www.youtube.com/watch?

v=Blqei6_s6J0&list=UUPLXxewjAvEBrO9DuLERbbQ.

Correct BP measurements require that the clinician listen through a stethoscope

that is placed over the brachial artery for the appearance of the five phases of the

Korotkoff sounds. Each sound has distinct features, which are depicted in Figure 9-

1.

6 Examples of Korotkoff sounds can be found in the Thinklabs Medical Sound

Library

(http://www.thinklabsmedical.com/stethoscope_community/Sound_Library)

under Blood Pressure—Korotkoff Sounds 1 and Blood Pressure—Korotkoff Sounds

2.

Table 9-1

Auscultatory Method for Blood Pressure Measurement in Adults as

Recommended by the American Heart Association

5

PATIENT: Patient should be seated for 5 minutes with arm bared, unrestricted by clothing, and supported at

heart level. Smoking or food ingestion should not have occurred within 30 minutes before the measurement

CUFF: An appropriately sized cuff should be used. The internal inflatable bladder width should be at least

40% of the bladder length and cover at least 80% of the upper arm circumference. The cuff should be

wrapped snugly around the arm with the center of the bladder over the brachial artery

MONITOR: Measurements should be taken with a correctly calibrated mercury sphygmomanometer, an

aneroid manometer, or a validated electronic device

PALPATORY METHOD: SBP should be estimated using the palpatory method. The cuff is rapidly inflated

in 10-mm Hg increments, while simultaneously palpating the radial pulse on the patient’s wrist on the cuffed

arm and observing the manometer. The pressure when the radial pulse is no longer palpable is the estimated

SBP. The cuff is then deflated rapidly

KOROTKOFF SOUNDS: The head of the stethoscope, ideally using the bell, should be placed over the

brachial artery, with each earpiece in the clinician’s ear. The cuff should then be rapidly inflated to 20–30

mm Hg above the estimated SBP from the palpatory method. The cuff is slowly deflated at a rate of 2 mm

Hg/second while the clinician simultaneously listens for phase 1 (the first appearance of sounds) and phase 5

(the disappearance of sounds) Korotkoff sounds while also observing the manometer. When the pressure is

10 to 20 mm Hg below phase 5, the cuff can be rapidly deflated

DOCUMENTATION: BP values should always be recorded. The BP values (SBP/DBP) should be

recorded using even numbers (rounded up from an odd number)

a along with the patient’s position (seated,

standing, or supine), arm used, cuff size, time, and date

REPEAT: A second measurement should be taken after at least 1 minute in the same arm. If the readings

differ by more than 5 mm Hg, additional measurements should be obtained. The mean of these values should

be used to make clinical decisions. BP should be taken in both arms at the initial visit with the BP measured

in the arm with the higher reading at subsequent visits

aTerminal digit preference (i.e., tendency to report readings that end in 0 or 5) should be avoided.

BP, blood pressure; DBP, diastolic blood pressure; SBP, systolic blood pressure.

Out-of-Office Blood Pressure Monitoring

Home BP measurements can provide information on response to therapy and may

help improve adherence to therapy and goal BP achievement in some patients.

7,8

Devices for home measurement should be validated for accuracy according to

established protocols from either the British Hypertension Society or the Association

for Advancement of Medical Instrumentation. When placed in service, they should be

routinely checked against office-based readings for accuracy, especially when

readings between office and home are widely discrepant. Patients with average home

BP values greater than 135/85 mm Hg are considered hypertensive.

7 Wrist or finger

devices that measure BP are generally not accurate and should not be routinely used.

p. 134

p. 135

Figure 9-1 Phases of the Korotkoff sounds heard when indirectly measuring blood pressure.

Ambulatory blood pressure monitoring (ABPM) typically measures BP every 15

to 30 minutes throughout the day and nighttime using a portable, noninvasive

oscillometric device typically worn for 24 hours.

5 This form of specialized

monitoring is indicated for patients with suspected white-coat hypertension and may

also be helpful in patients with apparent drug resistance, hypotensive symptoms

while receiving antihypertensive therapy, episodic hypertension, and autonomic

dysfunction.

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