BLOOD PRESSURE - Columbia University



BLOOD PRESSURE: GUIDELINES AND INTERVENTIONS

|BP |CATEGORY |INTERVENTION |WORK UP |PHARMACOLOGY |

|BP< 90% |Normal |Recheck BP at next visit |NONE |NONE |

| | |Discuss lifestyle changes | | |

|90% < BP 120/80 | |Discuss lifestyle changes |Fasting glucose | |

| | | |(if pt is overweight ) | |

|95% < BP < 99% + 5mmHg |Stage I HTN |Repeat over 2 more visits within 1-2 wks or sooner if |H&P |Compelling Indications: |

| | |symptomatic |CBC |Chronic kidney disease |

| | |Discuss lifestyle changes |BUN |Diabetes Mellitus |

| | |If HTN persists, evaluate further or refer to |Creatinine |Heart failure or LVH |

| | |specialist w/in 1 month |Electrolytes | |

| | |Pharmacological therapy indicated only with regular or |Urinalysis | |

| | |compelling indications. |Urine Cx |Regular Indications: |

| | | |Fasting lipid panel |Symptomatic HTN |

| | | |Fasting glucose |Secondary HTN |

| | | |Retinal Exam |Hypertensive target |

|BP > 99% + 5mmHg |Stage II HTN |Evaluate further immediately or refer to specialist |Renal Ultrasound | organ damage |

| | |w/in 1 wk or immediately if symptomatic. |ECHO |Diabetes (I or II) |

| | |Discuss lifestyle changes |Polysomnography (if hx of snoring) |Persistent HTN despite non-pharmacologic |

| | |Pharmacological therapy indicated |Drug Screen (if |measures |

| | | |hx indicates) | |

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