Hypertension

Definition

Hypertension is persistent elevation of blood pressure. AHA/ACC 2017 thresholds: Normal less than 120/80, Elevated 120 to 129/less than 80, Stage 1 130 to 139/80 to 89, Stage 2 ≥140/≥90.

Risk Factors

• Age, family history, African American ancestry
• Obesity, high sodium intake, sedentary lifestyle
• Tobacco and alcohol use
• Diabetes, chronic kidney disease
• Stress

Complications

Stroke, MI, heart failure, CKD, retinopathy, peripheral vascular disease.

Management

• Lifestyle: DASH diet, reduced sodium (less than 2.3 g/day), physical activity, weight management, limit alcohol, smoking cessation.
• Medications: Thiazide diuretics (first line for many), ACE inhibitors or ARBs (especially with diabetes/CKD), calcium channel blockers, beta-blockers.

Nursing Considerations

Teach home BP monitoring (2 readings, arm at heart level, sitting, no caffeine/smoking 30 min prior). Orthostatic precautions. Monitor for hypertensive crisis (>180/>120). Emergency evaluation.

NCLEX Relevance

'Silent killer.' DASH diet and medication adherence teaching.