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Table 7: High blood pressure phenotypes based on urgency or cardiovascular risk |
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Phenotype |
Urgency |
Cardiovascular risk |
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Definition |
Major: Severe elevation of diastolic BP > 90 mmHg systolic > 180 mmHg that carries the risk of target organ damage and/or death. Minor: Severe elevation of diastolic BP > 90 mmHg systolic < 180 mmHg that does not carry a risk of target organ damage and/or death. |
It depends on the severity of high blood pressure and the association with conventional cardiovascular risk factors and/or metabolic syndrome (MS). |
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Etiology |
Multifactorial |
Multifactorial |
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Pathophysiology |
Unknown |
Increased cardiac output and vascular resistance, in patients with MS an increase in insulin resistance is observed. |
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Prognosis |
Increased risk of death and cardiovascular and cerebral morbidity. |
It depends on severity which is divided into low when the risk of cardiovascular mortality is less than 2%, moderate between 2 and 10%, and high to very high when it is 10%. Patients with diabetes mellitus, target organ damage, frail or MS are considered to be at very high risk. |
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Treatment |
Major: It is treated in an emergency department with specialized treatment mainly with intravenous antihypertensive drugs. Minor: Can be treated in the office with fast-acting drugs and combinations. |
Low risk: Changes in lifestyle and monotherapy. Moderate, high and very high risk: Changes in lifestyle and combination therapy. Frail: Changes in lifestyle and monotherapy. |
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MS = Metabolic syndrome |
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