Cardiology · Overview · 2 min read

Essential Hypertension

Essential hypertension is sustained BP elevation without secondary cause. ACC/AHA stages: 1 = 130-139/80-89 mmHg, 2 = at least 140/90 mmHg. General target below 130/80 mmHg.

Key points

  • Stage 1: 130-139/80-89 mmHg; Stage 2: at least 140/90 mmHg.
  • Drug therapy for stage 1 starts when 10-year ASCVD risk is at least 10% or with CV/DM/CKD comorbidity.
  • First-line classes: thiazide, CCB, ACE-inhibitor, ARB.
  • SPRINT: target below 120 mmHg systolic cuts CV events by 25% over 3.3 years.
  • Hypertensive emergency: lower BP by no more than 25% within first hour, then to 160/100 mmHg over 6 hours.

Exam relevance

USMLE Step 1USMLE Step 2PLAB 2MRCP

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