title: Hypertension criterion for stroke prevention--to strengthen the principle of individualization in guidelines.
abstract: The diagnosis of hypertension, as recommended by most guidelines, is determined by systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. A threshold-based definition of hypertension, however, ignores sex and age, pathophysiology, and disparities in patient-specific conditions. Moreover, the harmful effects of hypertension-induced target organ damage cannot be ignored. Although the principle of individualization for hypertension management is recommended, especially for stroke prevention, how to practice it in a clinical setting has not been clearly elaborated. Therefore, we put forward a proposal for individualized hypertension management incorporating target organ damage, the main harmful effect of hypertension. We propose that hypertension should be diagnosed when an individual's blood pressure exceeds some difference from their own baseline in young adulthood, accompanied by any hypertension-induced target organ damage, confirmed by various detection methods. Application of this proposal to stroke prevention will hopefully strengthen the principle of individualized hypertension management.
authors.affiliation: Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Yicong
authors.initials: Y
authors.lastname: Chen
authors.forename: Xinran
authors.initials: X
authors.lastname: Chen
authors.forename: Ge
authors.initials: G
authors.lastname: Dang
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Zhao
authors.forename: Fubing
authors.initials: F
authors.lastname: Ouyang
authors.forename: Zhenpei
authors.initials: Z
authors.lastname: Su
authors.forename: Jinsheng
authors.initials: J
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D019468:Disease Management; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D057285:Precision Medicine / Q000592:standards*; D012737:Sex Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents