Hypertension

Measurement of blood pressure


A good measurement of the blood pressure is important, and more than one measurement is needed. The cuff should be 2/3 of the length of the upper arm. When the cuff is too small, it will give a falsely high reading. When too big, it will be falsely low.

Normal systolic blood pressure:
80 + (age in years x 2)

Diastolic blood pressure: 2/3 of systolic blood pressure

AGE SYSTOLIC BP
Newborn (term) 50 to 70 mm Hg
Under 1 year 70 to 90 mm Hg
1 to 5 years 80 to 100 mm Hg
5 to 12 years 90 to 110 mm Hg
Over 12 years 100 to 120 mm Hg

General


Longstanding hypertension will give cardiovascular and cerebrovascular damage. A hypertensive crisis will cause encephalopathy and retinopathy.

Causes

Important points in history

Headache, visual disturbances, fits, vomiting, shortness of breath, frequent nose bleeds

Important points in examination

Investigations

Try to find the cause of the hypertension, dependent on history and examination. For example:

Treatment

General Treatment

Drug Treatment

When hypertensive crises/ encephalopathy or chronic hypertension: aim to reduce the BP to normal levels over 48-72 hours. (Rapid reduction may cause stroke or blindness).

Follow up

in general clinic