nursing
,HYPERTENSION (HTN)
Comprehensive Nursing Notes & Clinical Care Guide
TABLE OF CONTENTS
1. Definition & Overview
2. Classification & Categories
3. Epidemiology & Risk Factors
4. Pathophysiology
5. Signs & Symptoms
6. Diagnostic Criteria & Assessment
7. Nursing Assessment
8. Nursing Diagnoses (NANDA)
9. Nursing Interventions & Care Plans
10. Pharmacological Management
11. Non-Pharmacological Interventions
12. Hypertensive Emergencies
13. Complications & Target Organ Damage
14. Patient Education & Discharge Planning
15. Special Populations
1. DEFINITION & OVERVIEW
Hypertension (HTN) is a chronic medical condition characterized by
persistently elevated blood pressure (BP) in the systemic arteries, defined as
systolic BP ≥130 mmHg and/or diastolic BP ≥80 mmHg (ACC/AHA 2017
Guidelines).
Key Fact: Hypertension affects approximately 1.28 billion adults
worldwide (WHO, 2021) and is the leading modifiable risk factor for
cardiovascular disease, stroke, and chronic kidney disease. It is
responsible for 10.8 million deaths annually globally.
nursing
,Core Problem
• Increased peripheral vascular resistance and/or increased cardiac
output
• Sustained elevation of arterial pressure leading to target organ damage
• Often asymptomatic — “silent killer”
2. CLASSIFICATION & CATEGORIES
ACC/AHA 2017 Blood Pressure Categories (Adults ≥18 years)
Category Systolic BP (mmHg) Diastolic BP (mmHg)
Normal <120 and <80
Elevated 120-129 and <80
Hypertension Stage 1 130-139 or 80-89
Hypertension Stage 2 ≥140 or ≥90
Hypertensive Crisis >180 and/or >120
European Society of Hypertension (ESH) / European Society of Cardiology
(ESC) 2023 Classification
Category Office BP (mmHg)
Optimal <120 / <80
Normal 120--84
High Normal 130--89
Grade 1 HTN 140--99
Grade 2 HTN 160--109
Grade 3 HTN ≥180 / ≥110
Isolated Systolic HTN ≥140 / <90
Types of Hypertension
Primary (Essential) Hypertension
• Prevalence: ~90-95% of all hypertension cases
nursing
, • Etiology: Multifactorial; no single identifiable cause
• Contributing factors: Genetics, lifestyle, obesity, sodium sensitivity,
stress, aging
• Onset: Gradual, usually develops over years
• Management: Lifestyle modification + pharmacological therapy
Secondary Hypertension
• Prevalence: ~5-10% of all hypertension cases
• Etiology: Identifiable underlying cause
• Onset: Often abrupt, severe, or resistant to treatment
• Common causes:
System Cause Clues
Renal Chronic kidney disease, Elevated creatinine,
renal artery stenosis proteinuria, abdominal
bruit
Endocrine Primary aldosteronism, Hypokalemia, weight
Cushing’s, changes, episodic
pheochromocytoma, headaches/sweating
thyroid disease
Vascular Coarctation of aorta Diminished femoral
pulses, BP discrepancy
arms vs legs
Neurological Obstructive sleep Snoring, daytime
apnea, intracranial somnolence, morning
tumors headaches
Medications NSAIDs, oral Temporal relationship
contraceptives, steroids, with medication use
decongestants,
stimulants
Pregnancy Preeclampsia, New-onset HTN after 20
nursing
,HYPERTENSION (HTN)
Comprehensive Nursing Notes & Clinical Care Guide
TABLE OF CONTENTS
1. Definition & Overview
2. Classification & Categories
3. Epidemiology & Risk Factors
4. Pathophysiology
5. Signs & Symptoms
6. Diagnostic Criteria & Assessment
7. Nursing Assessment
8. Nursing Diagnoses (NANDA)
9. Nursing Interventions & Care Plans
10. Pharmacological Management
11. Non-Pharmacological Interventions
12. Hypertensive Emergencies
13. Complications & Target Organ Damage
14. Patient Education & Discharge Planning
15. Special Populations
1. DEFINITION & OVERVIEW
Hypertension (HTN) is a chronic medical condition characterized by
persistently elevated blood pressure (BP) in the systemic arteries, defined as
systolic BP ≥130 mmHg and/or diastolic BP ≥80 mmHg (ACC/AHA 2017
Guidelines).
Key Fact: Hypertension affects approximately 1.28 billion adults
worldwide (WHO, 2021) and is the leading modifiable risk factor for
cardiovascular disease, stroke, and chronic kidney disease. It is
responsible for 10.8 million deaths annually globally.
nursing
,Core Problem
• Increased peripheral vascular resistance and/or increased cardiac
output
• Sustained elevation of arterial pressure leading to target organ damage
• Often asymptomatic — “silent killer”
2. CLASSIFICATION & CATEGORIES
ACC/AHA 2017 Blood Pressure Categories (Adults ≥18 years)
Category Systolic BP (mmHg) Diastolic BP (mmHg)
Normal <120 and <80
Elevated 120-129 and <80
Hypertension Stage 1 130-139 or 80-89
Hypertension Stage 2 ≥140 or ≥90
Hypertensive Crisis >180 and/or >120
European Society of Hypertension (ESH) / European Society of Cardiology
(ESC) 2023 Classification
Category Office BP (mmHg)
Optimal <120 / <80
Normal 120--84
High Normal 130--89
Grade 1 HTN 140--99
Grade 2 HTN 160--109
Grade 3 HTN ≥180 / ≥110
Isolated Systolic HTN ≥140 / <90
Types of Hypertension
Primary (Essential) Hypertension
• Prevalence: ~90-95% of all hypertension cases
nursing
, • Etiology: Multifactorial; no single identifiable cause
• Contributing factors: Genetics, lifestyle, obesity, sodium sensitivity,
stress, aging
• Onset: Gradual, usually develops over years
• Management: Lifestyle modification + pharmacological therapy
Secondary Hypertension
• Prevalence: ~5-10% of all hypertension cases
• Etiology: Identifiable underlying cause
• Onset: Often abrupt, severe, or resistant to treatment
• Common causes:
System Cause Clues
Renal Chronic kidney disease, Elevated creatinine,
renal artery stenosis proteinuria, abdominal
bruit
Endocrine Primary aldosteronism, Hypokalemia, weight
Cushing’s, changes, episodic
pheochromocytoma, headaches/sweating
thyroid disease
Vascular Coarctation of aorta Diminished femoral
pulses, BP discrepancy
arms vs legs
Neurological Obstructive sleep Snoring, daytime
apnea, intracranial somnolence, morning
tumors headaches
Medications NSAIDs, oral Temporal relationship
contraceptives, steroids, with medication use
decongestants,
stimulants
Pregnancy Preeclampsia, New-onset HTN after 20
nursing
