Classification of hypertension according to organ damage
Given the variability of blood pressure, the classification of hypertension as a function of blood pressure values has little reliability
It has been flanked by a three-stage classification by the WHO according to the existence and severity of target organ impairment.
Classification of hypertension on the basis of organ damage (World Health Organisation, International Society of Hypertension, (1993)
Stage I: Absence of objective signs of organ damage
Stage II: At least one of the following signs of organ damage
Left ventricular hypertrophy (Rx,ECG,Echo)
Generalised and focal narrowing of the retinal arteries
Proteinuria and/or slight increase in creatinineemia (1.2-2.0 mg/dL)
Atherosclerotic plaques in the carotid, aortic, iliac or femoral arteries (X-ray, Echo-Doppler)
Stage III: angina pectoris, myocardial infarction, heart failure
TIA, stroke, hypertensive encephalopathy
retinal haemorrhages and exudates with or without papilledema
creatininemia > 2.0 mg/dL
dissecting aneurysm of the aorta, symptomatic occlusive arteriopathy
This classification has the advantage of aiding the physician in the prognostic assessment and planning of therapeutic intervention.
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