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1. Find synonyms Q Find exact match A te AAA Wa IN d ete Kaa berati be ai Por paian ua Arpetaren heeh teen Me meal iamma fare iw ang staae 11 Te aree AAA Wa aa AA Wa AI wy eens WA Steet fe eee WA Meed ke eee et Ne oram Mam em eters petted AA of heprean AA te Greta free WAA aes WI oo 6 eed Pere She teeny Geter mea AA serme ite eat Note HA Ma ai ager fe ere omge of ime AA papet eee el Of fave mere pioto efter an wre ooreo tet pemes testes 2 AAA ond postem 69 mmen aaa aa 120 FP emmy or Wa BD AA AA AA ewe WAA UA mme w aor BO FP AY gn 1k i 2 e eee e e gt Find text within topics Click Find and enter the text for which you want to search Select Find synonyms if you want to find both exact matches and synonyms or select Find exact match if you want to find only exact matches Click Find to highlight all occurrences of the text To clear highlighted text click Clear DEFINITIONS 9 Hypertension Malignant hypertension ma 9 Hypertensive urgency MEET hte AAA OW ae ane O WWE Peet FT eT ON Dep ee WAWA OE ceed pg eee O temes an SA AI aa me Fee ee teres e bess IAA memi e Spee ee Sere terest oe 4 meres mess p tee ecm eee tte e mien et ee KAA Wa ee a eee ee m l Fame te egw of HES wee AAA y qemen nerw or o yus f2. UpToDate Wolters Kluwer UpToDate TAP INTO THE WORLD S LARGEST CLINICAL COMMUNITY For 19 years UpToDate has been providing our community of over 450 000 clinicians with unbiased continuously updated evidence based practical recommendations to make the right point of care decisions UpToDate is one of the world s most trusted clinical information resources In fact independent research shows that clinicians turn to UpToDate more than almost any other resource to find answers to their clinical questions Find out for yourself why your colleagues prefer UpToDate to other information resources 1 Source Schilling LM et al Acad Med 2005 80 1 51 Clinicians viewed over 150 million UpToDate topics last year and this number continues 10 grow COMPREHENSIVE FEATURES UpToDate is committed to helping you find information guickly and easily Here are some of the features we ve added over the past 19 years New Graphics search allows you to search over 23 000 authoritative graphics and view results in easy to scan thumbnail format Directly access topics that reference the graphic for more information Export print or email as needed A browser plug in that can be added to your IE or FireFox browser allowing you to access UpToDate right from your browser home page Links to full text for referenced articles provided your institution subscribes to a service that allows this access What s Ne
3. H Sees bees au eed a deed ear Eibert eee oe nee ee bees eed ec of ee ei ee ed er Ss eee YI N embii a Egr eel aed Cie oy Be o in 1 159 ee Pe ee ip I h Pa ee eed te ee ae eee T id es PA ra ra e mpi ai midjil aaa ar hark di te Aa Bent wine AA PA o cee ma Payee ia i Sper Bee ie ey aaa Bap Li mea hid gji eet ae Koi ey pee mrri te beet gece maj odd ed bee fee T ae F EH aa ee rd hee De ede Mii ed YA Use topic outlines Click on a heading in the outline to access the corresponding section of the topic The topic outline also includes links to related topics and associated graphics View All graphics associated with a topic in a thumbnail format Search Results for overview of hypertension in adults All Topics r Tebes et epee iie mip piai anuai mrin pisi aa Aa eee ee wma ney Spd of fe cet erie Se bier beeen aa eae iwa Let ees by bo agree m eed sv cee ed eee tee ea a A d are r metea pee kaa ii imaa fein B De e er egen r p al pp b Megare hmar a amin Kub e iata Prioritize the order in which topics appear on the Search Results page or filter your search over Graphics only View the titles in the default order All Topics or choose to prioritize the relevant list of topics by Adult Pediatric or Patient Select Graphics to view all relevant graphics in thumbnail format
4. ew y iorta ise Pee y 601 ae SOR detid spots 1 Ot IIIA e am mro emma peeh be g ove owe bnn w Eas Derr 0 moe wena ete me osure m ee ee bee ee SS De petes urea YA paa Access topics from the Search Results page Click on a topic title to display the topic position the mouse pointer over the topic title to view the topic outline And click on a heading within the outline to link to a specific section Drug Interactions o m YA AA a E ee ee WA mae me Wa Bene Access the drug interactions database online only Click on the highlighted arrow on the search screen to review drug to drug drug to herb and herb to herb interactions with the Lexi Interact drug interactions program In partnership with Lexicomp View the UpToDate demo at www uptodate com demo Adult and Pediatric Emergency Medicine Adult Primary Care and Internal Medicine Allergy and Immunology Cardiovascular Medicine Endocrinology and Diabetes Family Medicine Gastroenterology and Hepatology General Surgery Geriatrics Hematology Hospital Medicine Infectious Diseases Nephrology and Hypertension Neurology Obstetrics Gynecology and Women s Health Oncology Pediatrics Pulmonary Critical Care and Sleep Medicine Rheumatology Dermatology Psychiatry Wolters Kluwer UpToDate Health 95 Sawyer Road Waltham MA 02453 UpT
5. neh auntie Yonpharmacologic therapy recommendations Drug treatment General efficacy Initial monotherapy in uncomplicated hypertension Combination thera Provide valuable 9 Goal blood pressure feedback e Resistant hypertension 9 Discontinuing therapy INFORMATION FOR PATIENTS REFERENCES View all Graphics associated with a topic in a thumbnail format cs FIGURES 9 CHD mortality v BP and age hypertension rev htn in men women in US Use the Find tool to search for a word or synonym within a topic Print text references graphics or the entire topic Access patient information to share with your patients Submit questions and comments to our editors News from UpToDa Contact us Overview of hypertension in adults Authors Section Editor Deputy Editor Frank 2 Domino MD George L Bakris MD John P Forman MD MSc A wa Email topics to Norman M Kaplan A Disclosures your colleagues or patients Last literature review version 19 2 May 2011 This topic last updated February 14 2011 More INTRODUCTION The treatment of hypertension is the most common reason for office visits of non pregnant adults to physicians in the United States and for use of p escription drugs 1 Analysis of NHANES data from 1999 2000 and United States Census bureau information results in an approximately 29 to 31 percent in idence of hypertension in the 18 year and older po
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7. pulation of the United States 2 3 This translates into 58 to 65 million hypertensives in the adult population in the United States which is substantially higher than the 43 2 million estimate derived from the 1988 1991 NHANES III survey 3 4 View the date when the topic was last updated The number of patients with hypertension is likely to grow as the population ages since either isolated systolic hypertension or combined systolic and diastolic hypertension occurs in over one half of persons older than 65 years figure 1 5 The rising incidence of obesity will also increase the number of hypertensive individuals 5 See Treatment of hypertension in the elderly patient particularly isolated systolic hypertension Despite the prevalence of hypertension and its associated complications control of the disease is far from adequate 6 8 Data from NHANES show that only 34 percent pf persons with hypertension have their blood pressure under control defined as alleve below 140 90 mmHg table 1 7 Slightly higher rates of control Were reported in a regional population study approximately 45 and 55 percent of Men and women respectively have controlled hypertension 4 There are numefous potential reasons for low rates of blood pressure control including poor acces to health care and medications and lack of adherence with long term therapy for a condition that is usually asymptomatic 9 The latter may be particularly true when the
8. therapy may interfere with the patient s quality of life and when its immediate benefits may not be obvious to the patient Thus hypertension will likely remain the most common risk factor for heart attack and stroke 10 Link to information about authors and editors The definition complications diagnosis evaluation and management of hypertension are reviewed here Detailed discussions of all of these issues are found separately See appropriate topic reviews DEFINITIONS Access related topics to find addi tional information Hypertension Major societies have published definitions of hypertension as will be described below Hypertension was defined as a blood pressure 2140 290 mmHg However subsequent trials have identified groups of patients at higher risk in whom goal blood pressures below this value may be associated with improved outcomes See Goa blood pressure below The following definitions were suggested in 2003 by the seventh report of the Joint National Committee JNC 7 based upon the average of two or more properly measured readings at each of two or more visits after an initial screen 7 Normal blood pressure systolic lt 120 mmHg and diastolic lt 80 mmHg e Prehypertension systolic 120 139 mmHg or diastolic 80 89 mmHg e Hypertension Click to view a Medline abstract Stage 1 systolic 140 159 mmHg or diastolic 90 99 mmHg Stage 2 systolic 21160 or diastolic 2100 mmHg Isolated s
9. w a summary of important new findings by specialty including Practice Changing UpDates CME credit CE contact hours CPD time tracking available when you access UpToDate from your hospital intranet or EMR A drug database and interactions program in partnership with Lexicomp with over 5 000 adult pediatric international and natural drugs Over 125 clinical calculators which eliminates the need to remember formulas or use separate devices Over 700 patient information topics to help you educate your patients and encourage shared decision making A feedback button that allows you to submit questions and comments to our editors News from UpToDate a page that includes recent content updates training opportunities and links to our newsletter Link to our newsletter UpToDate by specialty since the last release View a detailed outline within each topic Pathogenesis Risk factors SECONDARY HYPERTENSION COMPLICATIONS DIAGNOSIS 9 Screening 9 Measurement 9 White coat hypeftension and ambulatory monitoring Masked hypertension Indications for ABPM Click on a heading to go directly tothe f evacuation information you need 2277 sical examination 9 Laboratory testing Additional tests Testing for renovascular nypertension Testing for other causes of identif able hypertension TREATMENT its of blood pressure Bene should be treated Review treatment S Ne
10. ystolic hypert be present when the bi sion is considered to be present when the blood pressure is 2140 lt 90 mmHg and isolated diastolic hypertension is considered to pressure is lt 140 290 mmHg These definitions apply diastolic pressures the age of 50 to 60 11 adults on no antihypertensive medications and who are not acutely ill If there is a disparity in category between the systolic and igher value determines the severity of the hypertension The systolic pressure is the greater predictor of risk in patients over the Help improve UpToDate Did UpToDate answer your question Yes No Measurement How to Answer Clinical Questions in UpToDate New Search Drug Interachons B u pae et et ed Enter a word or phrase in the New Search box The more specific your search the more likely it will return the desired results If you want to search just Graphics select this option in the drop down S ea a H 11 ets ee dae eee ey Tia ee bain ee ies 11 2211 Pee keira mi hie dete tet an FE VP A aa DIAGNOSIS Pa Da j Wawa Kana ai Wama Wa eee Fe ee a 9 Screening BRE ceeds Gate a P ieee wie bae aside bade Pee bait pee 152 E ed jinan tes ate tone as ee i PT ef gy Page Se akg mgd PL ae WA peered a ha ol mmr oceans hase 9 White coat hypertension and ambulatory monitoring Masked hypertension _Indications for ABPM 88 E Ei R RET
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