Hypertensive disease risk stratification

  Treatment decisions for hypertensive patients are based not only on blood pressure levels but also on the following aspects: A, risk factors for cardiovascular disease; B, target organ damage or diabetes mellitus; C, coexisting clinical conditions, such as cardiovascular, cerebrovascular disease and renal disease; D, patient’s personal situation and economic conditions, etc.  Risk factors: pulse pressure (elderly), >55 years for men and >65 years for women, smoking, dyslipidemia, diabetes, family history of early-onset cardiovascular disease (first-degree relatives, age of onset <50 years), abdominal obesity or obesity, lack of physical activity, elevated C-reactive protein.  Target organ damage: left ventricular hypertrophy, arterial wall thickening, mildly elevated serum creatinine, microalbuminuria.  Patients were divided into the following 4 groups according to their risk level: 1. Low-risk group: men aged <55 years and women aged <65 years, with grade 1 hypertension and no other risk factors.  2. Intermediate risk group: hypertension grade 2 or grade 1-2 with 1-2 risk factors.  3.High-risk group: including hypertensive patients with 3 risk factors, grade 1 or 2 with diabetes or target organ damage, and grade 3 hypertensive patients without other risk factors.  4, Very high risk group: hypertension grade 3 with more than 1 risk factor at the same time or with diabetes or target organ damage, or hypertension grade 1-3 with clinically relevant diseases.