Judgment for Medical Attention

Medical diagnosis of hypertension

Most patients with hypertension do not have typical symptoms, so it’s easily overlooked and not promptly treated. This suggests that high-risk groups should understand the general symptoms of hypertension and seek medical attention as soon as possible if they feel any discomfort. For general people, if there is any indication of elevated blood pressure during any medical consultation or physical examination, they should pay attention and have regular follow-up examinations to allow professional doctors to make judgments on the elevated blood pressure.

Diagnostic Process

When typical symptoms of hypertension or related suspicious symptoms occur, patients should seek medical attention promptly. The diagnostic process is as follows:

1. A professional doctor confirms the diagnosis of hypertension and determines the classification of blood pressure level;

2. Determines the cause of hypertension;

3. Analyzes risk factors, target organ damage and related clinical symptoms, makes etiology and differential diagnosis, and evaluates the patient's cardiovascular and cerebrovascular risk factors.

Generally, patients with hypertension can take medication to control blood pressure, but if the following conditions occur, they need to be hospitalized for further diagnosis and treatment promptly:

- No confirmed cause;

- Hypertension has already caused target organ damage;

- There are obvious concomitant diseases or complications, such as pheochromocytoma, glomerulonephritis, renal artery disease, pregnancy poisoning, fundus changes, etc.;

- Severe complications, such as heart failure, cerebrovascular accident, etc.;

- Hypertensive crisis (≥180/120 mmHg).

Diagnostic Criteria

It is pointed out that without the use of antihypertensive drugs, there are 3 times when the clinic blood pressure values are higher than normal, that is, the clinic systolic blood pressure (commonly known as high pressure) ≥140mmHg and/or diastolic blood pressure (commonly known as low pressure) ≥90mmHg, and these 3 blood pressure measurements are not conducted on the same day, then it can be diagnosed as hypertension.

Please note that when systolic and diastolic blood pressure belong to different levels, the one that meets the higher level shall prevail, that is, the diagnostic criteria should be more stringent.

The 2022 "Guidelines for Clinical Practice of Hypertension" recommends that the diagnostic threshold of hypertension in adults in China be lowered to systolic blood pressure ≥130mmHg and/or diastolic blood pressure ≥80mmHg. It also states that the diagnosis of hypertension can be based on clinic blood pressure measurement, 24-hour dynamic blood pressure monitoring, or home blood pressure monitoring. If conditions permit, 24-hour dynamic blood pressure monitoring is preferred, but it has not yet been fully implemented.

Department of Consultation

The routine treatment department for hypertension is cardiology or general internal medicine. For hypertension with complex symptoms, one can go to the hypertension clinic specially set up in a qualified hospital for treatment.