Hypertension (Essential)
Cardiovascular · ~11% of blueprint- Pathophysiology
- Multifactorial ↑ systemic vascular resistance &/or cardiac output; most cases primary (essential). Sustained ↑afterload → LVH, vascular remodeling, end-organ damage.
- Signs & Symptoms
- Usually asymptomatic ('silent killer'), found on screening. End-organ clues: retinopathy, LVH, proteinuria. Severe: headache, visual changes.
- Gold Standard Diagnosis
- ≥2 elevated readings on ≥2 separate visits. AHA/ACC 2025: Stage 1 130–139/80–89, Stage 2 ≥140/90. Confirm with home/ambulatory BP.
- First-line Treatment
- Lifestyle + a first-line class: thiazide-type diuretic, ACEi, ARB, or long-acting dihydropyridine CCB. ACEi/ARB as part of treatment in CKD with moderate–severe albuminuria. Start 2 classes (single-pill combination) in stage 2.
High-Yield Pearl
Suspect secondary HTN if young, resistant, or abrupt: renal artery stenosis, hyperaldosteronism, pheochromocytoma, OSA.
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Sources
Reviewed September 2026- 2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults — AHA/ACC, 2025
- Implementing the 2025 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults — American Heart Association — Hypertension, 2025
- Case-Based Applications of the 2025 AHA/ACC/Multispecialty High Blood Pressure Guideline — American Heart Association — Hypertension, 2025
- StatPearls: Essential Hypertension — NCBI Bookshelf / StatPearls, 2025
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