Screening For Hypertension
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DEFNITION: Hypertension is defined as the level of systolic blood pressure of 140 mm Hg and above , or a level of diastolic pressure of 90 mm Hg or above.
MALES PREVALANCE (per 1000 persons) URBAN 59.9 RURAL
35.5
FEMALES 69.9 35.9
Initially moderate & severe hypertension was considered as important risk factor for vascular diseases. Recent studies shows that can cause complications. Effective method of diagnosis of hypertension is to the population. Screening that is not linked to follow up and treatment is a fruitless exercise.
Mass screening Out- patient clinics Hypertension screening camps
– most appropriate screening test for detecting asymptomatic hypertensive patients.
Patient should not have used tobacco or caffeine before 30 mins. Patient should be in quiet environment atleast 5 mins before recording BP. Position the manometer at eye level Use appropriate cuff size Support the arm horizontally. Apply stethoscope lightly on cubital fossa.
Increase 30 mmHg beyond the point at which radial pulse is no longer palpable. Decrease the pressure at the rate of 2-3 mm Hg / second. Systolic BP – appearance of sound Diastolic BP – disappearance of sound Use average of 2 readings. Measure both arms initially.
RECOMMENDED FOLLOW UP BASED ON INITIAL SCREENING BP SYSTOLIC BP in mm Hg
DIASTOLIC BP in mm Hg
RECOMMENDED FOLLOW UP
Recheck in 2 yrs Recheck in 1 yr
<130
< 85
130 – 140
85 – 90
140 – 180
90 – 105
180 – 210
105 – 120
Initiate treatment with in few wks
>210
> 120
Evaluate & treat immediately
Repeatedly every 3 m
A person should be diagnosed as hypertensive only after more than one elevated reading obtained on each of 3 separate visits over a period of one to several weeks.
Cost of drug regimen used to treat hypertension is an important determinant of the cost effectiveness of screening for blood pressure.
Prevention of complications Increase of expected life span
REFERENCES; Hypertension control – Report of WHO expert committee http://www.annals.org/cgi http://www.ncbi.n/m.nih.gov
MALES PREVALANCE (per 1000 persons) URBAN 59.9 RURAL
35.5
FEMALES 69.9 35.9
Initially moderate & severe hypertension was considered as important risk factor for vascular diseases. Recent studies shows that can cause complications. Effective method of diagnosis of hypertension is to the population. Screening that is not linked to follow up and treatment is a fruitless exercise.
Mass screening Out- patient clinics Hypertension screening camps
– most appropriate screening test for detecting asymptomatic hypertensive patients.
Patient should not have used tobacco or caffeine before 30 mins. Patient should be in quiet environment atleast 5 mins before recording BP. Position the manometer at eye level Use appropriate cuff size Support the arm horizontally. Apply stethoscope lightly on cubital fossa.
Increase 30 mmHg beyond the point at which radial pulse is no longer palpable. Decrease the pressure at the rate of 2-3 mm Hg / second. Systolic BP – appearance of sound Diastolic BP – disappearance of sound Use average of 2 readings. Measure both arms initially.
RECOMMENDED FOLLOW UP BASED ON INITIAL SCREENING BP SYSTOLIC BP in mm Hg
DIASTOLIC BP in mm Hg
RECOMMENDED FOLLOW UP
Recheck in 2 yrs Recheck in 1 yr
<130
< 85
130 – 140
85 – 90
140 – 180
90 – 105
180 – 210
105 – 120
Initiate treatment with in few wks
>210
> 120
Evaluate & treat immediately
Repeatedly every 3 m
A person should be diagnosed as hypertensive only after more than one elevated reading obtained on each of 3 separate visits over a period of one to several weeks.
Cost of drug regimen used to treat hypertension is an important determinant of the cost effectiveness of screening for blood pressure.
Prevention of complications Increase of expected life span
REFERENCES; Hypertension control – Report of WHO expert committee http://www.annals.org/cgi http://www.ncbi.n/m.nih.gov
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