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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