Age,race, sex and other indices of risk in hypertension

Among the various criteria used in evaluating the prognosis of hypertensive patients the level of the diastolic blood pressure averaged over three or more visits is the most important index. Other indices also are useful and are essential in deciding on treating patients with average diastolic blood pressures below 105 mm Hg. Included among these are sex, age and race. Male sex, young age and black race are all associated with increased risk of morbidity and mortality.The lability of the hypertension is another indicator of risk. Patients with labile hypertension—high casual in relation to basal blood pressure—have a better prognosis than those who do not. Family history also should be considered. A history of premature death from hypertensive complications in a parent or sibling suggests that the patient may be at increased risk. Finally, the presence and extent of detectable target organ damage provides a major criterion of prognosis and indication for treatment.