Page 67 - Clinical Pearls in Cardiology

Arterial Pulse and Blood Pressure 55

These drugs are nonsedating, and they do not cause an
increase in cerebral blood flow or intracranial pressure.
(Ref: Handbook of Neurosurgery, Greenberg, 7th edn,
Pg 1019, 1126).
39. How do you classify hypertension that occurs during
pregnancy?
Hypertensive disorders complicate 6% to 8% of
pregnancies. They can be classified as follows:
• Chronic hypertension: Blood pressure ≥ 140 mm Hg
systolic or ≥ 90 mm Hg diastolic that is present and
observable before the 20th week of pregnancy.
• Gestational hypertension: Blood pressure elevation,
without proteinuria, that is detected for the first time
after the first 20 weeks of pregnancy and returns to
normal by 12 weeks postpartum.
• Preeclampsia–eclampsia: Pregnancy-specific
syndrome of blood pressure elevation (blood
pressure >140 mm Hg systolic or > 90 mm Hg
diastolic) that occurs after the first 20 weeks of
pregnancy and is accompanied by proteinuria.
• Preeclampsia superimposed on chronic hyper-
tension: Chronic hypertension with superimposed
proteinuria and with or without signs of the
preeclampsia syndrome.
40. What are the clinical features suggestive of
renovascular hypertension?
The clinical clues that suggest the possibility of
renovascular hypertension (usually due to renal artery
stenosis) are the following:
Features suggesting renovascular disease
• Age of onset of hypertension (<30 or >55 years)
• Abrupt onset of hypertension