www.CHESTERCMS.org GUIDELINES 2017 First the definitions: TREATMENT Normal BP: Less than 120/80 mmHg Methodology of treatment is also different, and we have summarized it below: Elevated BP: Systolic between 120-129 mm Hg and diastolic less than 80 mm Hg. Stage 1 Hypertension: Systolic between 130-139 mm Hg and diastolic 80-89 mm Hg. Stage 2 Hypertension: Systolic greater than 140 mm Hg and diastolic greater than 90 mm Hg. Hypertensive Crises: Systolic over 180 mm Hg and diastolic greater than 120 mm Hg. There are significant changes in the new guidelines with previous stage 1 now designated as stage 2 and prehypertension is eliminated. With the new guidelines the prevalence of hypertension has increased from 39.9% to 45.6% according to JNC7 by current guidelines [72.2 million to 103.3 million]. They have also stressed the importance of proper technique of measuring and monitoring the BP. o Pharmacological treatment for stage 1 hypertension only if the patient has already had a cardiovascular event like myocardial infarction, stroke or is at high risk in the presence of diabetes mellitus, chronic kidney disease, or high 10-year risk of events based on risk factors. The rest of stage 1 hypertensive will be treated with lifestyle modification and close follow up. o Recognize that two medications may achieve better results. o Socioeconomic and psychosocial factors should be taken into account. o Life style modification with diet, exercise and weight loss are very important part of guidelines. continued on next page WINTER 2018 | CHESTER COUNT Y Medicine 9http://www.chestercms.org/index.html