We all remember the hypertension classification very well, but the cardiovascular risk level stratification is confusing, whether it is low risk, high risk or very high risk? Today we share this knowledge with you in the context of China’s hypertension guidelines.
Classification of blood pressure levels
If a patient’s systolic and diastolic blood pressure are in different levels, the higher classification will prevail.
Cardiovascular risk level stratification for hypertensive patients
Risk factors
1, hypertension (grade 1-3).
2, males > 55 years of age; females > 65 years of age.
3, smoking.
4, impaired glucose tolerance (2-hour glucose 7.8-11.0 mmol/L) and/or abnormal fasting glucose (6.1-6.9 mmol/L).
5. dyslipidemia; TC ≥ 5.7 mmol/L (220 mg/dL) or LDL-C > 3.3 mmol/L (130 mg/dL) or HDL-C < 1.0 mmol/L (40 mg/dL).
6, family history of early-onset cardiovascular disease (age of onset in first-degree relatives <50 years).
7, abdominal obesity (waist circumference: men ≥ 90 cm women ≥ 85 cm) or obesity (BMI ≥ 28 kg/m2).
8, hyperhomocysteine >10mmol/L.
Target organ damage
1, left ventricular hypertrophy: ECG: Sokolow-Lyons >38mv or Cornell >2440mm-mms; echocardiographic LVMI: male ≥125, female ≥120g/m2.
2, carotid ultrasound IMT>0.9mm or atheromatous plaque.
3, carotid-femoral pulse wave velocity >12m/s (optional use).
4, ankle/arm blood pressure index <0.9 (optional use).
5, estimated reduced glomerular filtration rate (eGFR <60ml/min/1.73m2); or mildly elevated serum creatinine: 115-133mmol/L in men and 107-124mmol/L in women.
6. Microalbuminuria: 30-300mg/24h or albumin/creatinine ratio: ≥30mg/g (3.5mg/mmol).
Associated clinical disorders
1, cerebrovascular disease: cerebral hemorrhage; ischemic stroke; transient ischemic attack.
2, cardiac disease: history of myocardial infarction; angina pectoris; history of coronary artery revascularization; congestive heart failure.
3. renal disease: diabetic nephropathy; impaired renal function; blood creatinine: men > 133 mmol/L; women > 124 mmol/L; proteinuria (> 300 mg/24h).
4. peripheral vascular disease.
5, retinopathy: hemorrhage or exudate, optic papillary edema.
6, diabetes mellitus
Fasting blood glucose: ≥7.0mmol/L.
Postprandial blood glucose: ≥11.1mmol/L.
Glycosylated hemoglobin: (HbA1c) ≥ 6.5%.