Hypertension Management

ISH 2020 · ESH 2023 · NICE 2023 · JNC8

1.28B
Adults affected globally
46%
Unaware they have HTN
7.5M
Annual deaths attributed
21%
Adults in Pakistan

Hypertension: Silent Killer

HTN is the leading modifiable risk factor for cardiovascular disease, stroke, and kidney failure. Most patients are asymptomatic — opportunistic screening at every GP visit is essential. Treating to target reduces stroke risk by 35–40% and MI risk by 20–25%.

Stroke Risk ↓35%MI Risk ↓20%HF Risk ↓50%CKD Progression ↓

Based on ISH 2020 & ESH 2023 guidelines. Diagnosis requires 2+ separate visits unless crisis.

NormalSBP <120 / DBP <80 mmHg

Reassess in 1–2 years. Promote lifestyle habits.

ElevatedSBP 120–129 / DBP <80 mmHg

Lifestyle modification. Reassess in 3–6 months.

Stage 1 HTNSBP 130–139 / DBP 80–89 mmHg

Lifestyle modification ± pharmacotherapy based on CVD risk.

Stage 2 HTNSBP ≥140 / DBP ≥90 mmHg

Lifestyle modification + pharmacotherapy. Reassess in 1 month.

Hypertensive CrisisSBP >180 / DBP >120 mmHg

Urgent assessment. Differentiate urgency vs emergency.

Diagnosis Note: Confirm with average of ≥2 readings on ≥2 separate occasions. Consider ABPM for white coat HTN or before starting treatment.

Clinical Algorithms

More decision flowcharts

Lab Reference

Renal & metabolic panels

Drug Database

Full dosing & interactions

Based on ISH 2020, ESH/ESC 2023, NICE NG136, JNC8 guidelines. Always individualize management. Refer complex cases to a specialist.