Category Hypertension Normal < 130/< 85 Recheck in 2 years. High Normal 130–139/ 85–89 Recheck in 1 year Hypertension Stage 1 (mild) 140–159/90–99 Confirm within 2 months Stage 2 (moderate) 160–179/100–109 Evaluate or refer within 1 month Stage 3 (severe) 180–209/110–119 Evaluate or refer within 1 week Stage 4 (very severe) > 210 /> 120 Evaluate or refer immediately

MANAGEMENT OF HYPERTENSION Primary (Essential) Hypertension Secondary Hypertension

Primary (Essential) Hypertension Sympathetic nervous system hyperactivity Renin-angiotensin system Defect in natriuresis Intracellular sodium and calcium Exacerbating factors

Secondary Hypertension Estrogen use Renal disease Renal vascular hypertension Primary hyperaldosteronism and Cushing's syndrome Pheochromocytoma Coarctation of the aorta Hypertension associated with pregnancy Other causes of secondary hypertension

ANTIHYPERTENSIVE DRUG THERPY

Antihypertensive drugs Diuretics. Beta-adrenergic blocking agents ACE inhibitors and angiotensin II blockers Calcium channel-blocking agents Alpha-adrenoceptor antagonists