Definition

Persistent elevation of SBP of 140mm Hg and/or DBP of 90mm Hg

Classifications

Malaysias guidelines

Australias guidelines









Basic and Clinical Pharmacology


TYPES OF HYPERTENSION
There are two major types of hypertension and four less frequently found types.
The two major types are:
Primary or essential hypertension, that has no known cause, is diagnosed in the
majority of people.
Secondary hypertension is often caused by reversible factors, and is sometimes
curable.
The other types include:
Malignant Hypertension.
Isolated Systolic Hypertension
White Coat Hypertension
Resistant Hypertension
Primary Hypertension
This type is also called essential hypertension, and it is by far the most common type of
hypertension, and is diagnosed in about 95% of cases. Essential hypertension has no
obvious or yet identifiable cause.
Secondary Hypertension:
This may be caused by:
Kidney damage or impaired function (This accounts for most secondary forms of
hypertension.)
Tumours or overactivity of the adrenal gland
Thyroid dysfunction
Coarctation of the aorta
Pregnancy-related conditions
Sleep Apnea Syndrome
Medication, recreational drugs, drinks & food
Malignant Hypertension
This, the most severe form of hypertension, is severe and progressive. It rapidly leads to
organ damage. Unless properly treated, it is fatal within five years for the majority of
patients. Death usually comes from heart failure, kidney damage or brain haemorrhage.
However, aggressive treatment can reverse the condition, and prevent its
complications. Malignant hypertension is becoming relatively rare, and is not caused by
cancer or malignancy.

Isolated Systolic Hypertension
In this case the systolic blood pressure, (the top number), is consistently above 160 mm
Hg, and the diastolic below 90 mm Hg. This may occur in older people, and results from
the age-related stiffening of the arteries. The loss of elasticity in arteries, like the aorta, is
mostly due to arteriosclerosis. The Western lifestyle and diet is believed to be the root
cause.
Latest studies confirm the importance of treating ISH, as it significantly reduces the
incidence of stroke and heart disease. Treatment starts with lifestyle modification, and if
needed, added drugs.
White coat hypertension
Also called anxiety-induced hypertension, it means blood pressure is only high when
tested by a health professional. If confirmed, with repeat readings outside of the clinical
setting, or a 24-hour monitoring device, it does not need to be treated. However, regular
follow-up is recommended to ensure that persistent hypertension has not developed.
Lifestyle changes like more exercise, less salt and alcohol, no nicotine and weight loss,
would be wise. A low fat, high fibre diet, with increased fruit and vegetable intake, will
be beneficial.
Resistant Hypertension
If blood pressure cannot be reduced to below 140/90 mmHg, despite a triple-drug regime,
resistant hypertension is considered.