How is hypertension diagnosed?

  I. Definition of hypertension In adults 18 years of age or older, a blood pressure ≥ 140 mmHg systolic and/or 90 mmHg diastolic on 3 non-same day measurements is diagnosed as hypertension. Non-same day 3 times, generally refers to the measurement of 2 weeks apart, not refers to today, tomorrow, the day after the non-same day.  Second, the classification of hypertension According to the blood pressure level, hypertension disease is subdivided into grade 1, grade 2, and grade 3.  Grade 1: systolic blood pressure 140-159 mmHg and/or diastolic blood pressure 90-99 mmHg; Grade 2: systolic blood pressure 160-179 mmHg and/or diastolic blood pressure 100-109 mmHg; Grade 3: systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. Risk stratification of hypertension Patients with hypertension often have a variety of risk factors at the same time, so paying attention only to blood pressure It is wrong to pay attention to the elevated blood pressure and ignore other risk factors. Therefore, patients with hypertension need to be stratified in terms of risk level.  The risk of a patient with hypertension depends not only on the level of blood pressure, but also on the presence of other risk factors and the combination of cardiovascular and cerebrovascular diseases. For example, in male patients with the same blood pressure of 145/90 mm Hg, the risk of a cardiovascular event within one year is 20 times higher in those over 60 years of age who also have diabetes mellitus and a history of transient ischemic attack compared to those under 40 years of age who have no history of diabetes mellitus or other cardiovascular disease. Therefore, it is essential to stratify hypertensive disease by risk.  Low risk: hypertension grade 1 with no other risk factors. This group of patients has <15% chance of developing cardiovascular disease within 10 years. Blood pressure should be observed for about one year before antihypertensive drug therapy.  Intermediate risk: hypertension grade 2, or hypertension grade 1 or 2 with 1 or 2 risk factors. This group of patients has a 15% to 20% chance of developing cardiovascular disease within 10 years. Blood pressure should be observed for 3 to 6 months, and if it definitely exceeds the normal standard before antihypertensive medication is administered.  High risk: hypertension grade 3, or hypertension grade 1 to 2 with ≥3 risk factors, or with any of the target organ damage, or with any of the clinical disorders. This group of patients has a 20-30% chance of developing cardiovascular disease within 10 years. Antihypertensive drug therapy should be implemented to control the coexisting risk factors.  The 2009 grassroots version of the Chinese Guidelines for the Prevention and Treatment of Hypertension simplified the risk stratification of the previous guidelines by combining the original high-risk and very high-risk into high-risk. Because the principles of treatment for high-risk and very high-risk are the same, both should be given medication immediately.  IV. Ancillary examinations Routine requirements (standard requirements): routine blood, routine urine, fasting blood glucose, lipids, renal function, electrocardiogram, X-ray chest film, ultrasound examination, and completion of urine microalbumin, fundus vasculature, and arterial stiffness (PWV) when possible.