2.7
Hypertension
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 2, Cardiovascular Diseases.
Clinical Description
- Diagnosis is based on a raised blood pressure measured while patient is at rest on at least 3 separate readings.
- Hypertension is generally asymptomatic.
- Essential hypertension is unusual in children and young adults and an underlying cause should be excluded at hospital level
- Hypertension in children is dependent on the age, sex, and height 1 to 13 years ≥ 13 years
Normal BP Systolic (SBP) and diastolic BP (DBP) < 90th percentile <120/80
Elevated BP (Previously prehypertension)
SBP and/or DBP ≥ 90th percentile but < 95th percentile
SBP 120-129, DBP <80
Stage 1 hypertension SBP and/or DBP ≥ 95th percentile to < 95th percentile + 12mmHg or 130/80 to 139/89 (whichever is lower) 130/80 – 139/89
Stage 2 hypertension SBP and/or DBP ≥ 95th percentile + 12 mmHg or ≥ 140/90 mmHg (whichever is lower)
BP ≥ 140/90
Causes include:
Renal disease (glomerulonephritis, Hemolytic uremic syndrome, renal failure, cystic renal disease)
- Renovascular (renal artery stenosis)
- Cardiovascular (coarctation of the aorta)
- Endocrine (Cushing’s Syndrome, neuroblastoma)
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