Persistent BP ≥140/90 (office) with no identifiable cause.
Risk factors
- • Age, obesity, salt intake, alcohol, family history
Investigations
- • ABPM/HBPM to confirm
- • U&E, glucose, lipids, urinalysis (ACR)
- • 12-lead ECG for LVH
- • Fundoscopy
Management
- • Lifestyle: DASH diet, salt <5 g, exercise, weight, alcohol <14 units/wk
- • Step 1: ACEi/ARB (<55 y non-black) or CCB (≥55 or black African)
- • Step 2: add other class
- • Step 3: add thiazide-like diuretic
- • Step 4: add spironolactone (if K ≤4.5) or α/β-blocker
Drug therapy
- • Target: <140/90 (<130/80 if diabetic or CKD with albuminuria)
- • SPRINT: <120 SBP in high-risk
Complications
- • Stroke, MI, HF, CKD, retinopathy
References
- • ESC 2023 HTN
- • NICE NG136 2019
Related in WardRound
Educational — verify locally.
