Evaluation and Treatment of Patients With Systemic Hypertension
Abstract
A 65-year-old man presented for evaluation of high blood pressure found on screening at a local health fair.History and physical examination did not show any signs or symptoms suggestive of a secondary cause, nor was there evidence of target end-organ damage except for grade 1 Keith-Wagener-Barker retinopathy.The patient denied taking any prescription or over-the-counter medications.Hypertension is the most common disease-specific reason Americans visit a physician.Despite the risks associated with an elevated blood pressure (BP), there is still woefully low achievement of recommended BP goals.From 1991 to 1994, only 27.4% of hypertensive Americans aged 18 to 74 years had a BP Ͻ140/90 mm Hg, the current stated goal for most people with hypertension, and in those with diabetes, less than half that number (11%) were controlled to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure VI (JNC VI) recommended goal of Ͻ130/85 mm Hg. 1 The present update will provide an overview of the evaluation and management of essential hypertension and help to guide clinicians in developing a management plan for a patient like the one described above.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
β-blockers, non-dihydropyridine calcium channel blockers, class Ic/III antiarrhythmics, and digoxin have been considered reversible causes of advanced AVB in clinical practice.
“B‐blockers, nondihydropyridine calcium channel blockers (non‐DHP CCBs), class Ic/III antiarrhythmics, and digoxin have been considered reversible causes of AVB in clinical practice [2, 3, 4].”
From Clinical Significance and Management of Atrioventricular Block Associated With Bradycardic/Antiarrhythmic Drug Therapy: Drug-Induced or Drug-Revealed? (2025) · cites this paper as [3]
The Calcium Antagonists section warns that combining a non-dihydropyridine calcium-channel blocker with a β-blocker can cause heart block. It does not describe the block as reversible or address class Ic/III antiarrhythmics or digoxin as causes of AV block. No page number is available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(2000) · New England Journal of Medicine · doi:10.1056/nejm200001203420301 · Cited by 8,663 · see citing works
Brenner, B. M., Cooper, M. E., de Zeeuw, D., Keane, W. F., Mitch, W. E., Parving, H.-H., Remuzzi, G., Snapinn, S. M., Zhang, Z., & Shahinfar, S. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011161 · Cited by 7,493 · see citing works
(1997) · Archives of Internal Medicine · doi:10.1001/archinte.157.21.2413 · Cited by 6,345 · see citing works
Lewis, E. J., Hunsicker, L. G., Clarke, W. R., Berl, T., Pohl, M. A., Lewis, J. B., Ritz, E., Atkins, R. C., Rohde, R., & Raz, I. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011303 · Cited by 5,987 · see citing works
Pfeffer, M. A., Braunwald, E., Moyé, L. A., Basta, L., Brown, E. J., Cuddy, T. E., Davis, B. R., Geltman, E. M., Goldman, S., Flaker, G. C., et al. (1992) · New England Journal of Medicine · doi:10.1056/nejm199209033271001 · Cited by 5,911 · see citing works
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101043440101 · Cited by 5,638 · see citing works
The Effect of Carvedilol on Morbidity and Mortality in Patients with Chronic Heart Failure
Packer, M., Bristow, M. R., Cohn, J. N., Colucci, W. S., Fowler, M. B., Gilbert, E. M., & Shusterman, N. H. (1996) · New England Journal of Medicine · doi:10.1056/nejm199605233342101 · Cited by 4,649 · see citing works
(1997) · Archives of Internal Medicine · doi:10.1001/archinte.1997.00440420033005 · Cited by 3,777 · see citing works
Multiple Risk Factor Intervention Trial
Michel, D. (1982) · JAMA · doi:10.1001/jama.1982.03330120023025 · Cited by 1,731 · see citing works
Human blood pressure determination by sphygmomanometry.
Perloff, D., Grim, C. M., Flack, J. M., Frohlich, E. D., Hill, M. D., McDonald, M., & Morgenstern, B. Z. (1993) · Circulation · doi:10.1161/01.cir.88.5.2460 · Cited by 1,592 · see citing works
Antman, E. M. (1992) · JAMA · doi:10.1001/jama.268.2.240 · Cited by 1,535 · see citing works
Preserving renal function in adults with hypertension and diabetes: A consensus approach
Bakris, G. L., Williams, M. E., Dworkin, L. D., Elliott, W. J., Epstein, M., Toto, R. D., Tuttle, K. R., Douglas, J. G., Hsueh, W. A., & Sowers, J. R. (2000) · American Journal of Kidney Diseases · doi:10.1053/ajkd.2000.16225 · Cited by 1,399 · see citing works
Self-citationWhelton, P. K., Appel, L. J., Espeland, M. A., Applegate, W. B., Ettinger, Jr., Kostis, J. B., Kumanyika, S., Lacy, C. R., Johnson, K. C., Folmar, S., et al. (1998) · JAMA · doi:10.1001/jama.279.11.839 · Cited by 1,200 · see citing works
Effect of Amlodipine on Morbidity and Mortality in Severe Chronic Heart Failure
Packer, M., O’Connor, C. M., Ghali, J. K., Pressler, M. L., Carson, P. E., Belkin, R. N., Miller, A. B., Neuberg, G. W., Frid, D. J., WERTHEIMER, J. H., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610103351504 · Cited by 1,194 · see citing works
Staessen, J. A., Gąsowski, J., Wang, J. G., Thijs, L., Hond, E. D., Boissel, J., Coope, J., Ekbom, T., Gueyffier, F., Liu, L., et al. (2000) · The Lancet · doi:10.1016/s0140-6736(99)07330-4 · Cited by 1,159 · see citing works
Estacio, R. O., Jeffers, B. W., Hiatt, W. R., Biggerstaff, S. L., Gifford, N., & Schrier, R. W. (1998) · New England Journal of Medicine · doi:10.1056/nejm199803053381003 · Cited by 1,158 · see citing works
Jafar, T. H., Schmid, C. H., Landa, M., Giatras, I., Toto, R., Remuzzi, G., Maschio, G., Brenner, B. M., Kamper, A., Zucchelli, P., et al. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-2-200107170-00007 · Cited by 1,092 · see citing works
Neaton, J. D. (1993) · JAMA · doi:10.1001/jama.270.6.713 · Cited by 949 · see citing works
Cardiovascular protection and blood pressure reduction: a meta-analysis
Staessen, J. A., Wang, J., & Thijs, L. (2001) · The Lancet · doi:10.1016/s0140-6736(01)06411-x · Cited by 945 · see citing works
Agodoa, L. Y. C. (2001) · JAMA · doi:10.1001/jama.285.21.2719 · Cited by 935 · see citing works
The Effects of Nonpharmacologic Interventions on Blood Pressure of Persons With High Normal Levels
Whelton, P. K. (1992) · JAMA · doi:10.1001/jama.1992.03480090061028 · Cited by 768 · see citing works
Fuster, V., Alexander, R. W., & O’Rourke, R. A. (1966) · Medical Entomology and Zoology · Cited by 705 · see citing works
Treatment of Mild Hypertension Study
Neaton, J. D. (1993) · JAMA · doi:10.1001/jama.1993.03510060059034 · Cited by 669 · see citing works
(1997) · Archives of Internal Medicine · doi:10.1001/archinte.1997.00440270105009 · Cited by 646 · see citing works
Keane, W. F., & Eknoyan, G. (1999) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(99)70442-7 · Cited by 588 · see citing works
Are β-Blockers Efficacious as First-line Therapy for Hypertension in the Elderly?
Messerli, F. H., Grossman, E., & Goldbourt, U. (1998) · JAMA · doi:10.1001/jama.279.23.1903 · Cited by 556 · see citing works
Brenner, B. M., Cooper, M. E., & de Zeeuw, D. (2002) · ACC Current Journal Review · doi:10.1016/s1062-1458(01)00549-9 · Cited by 508 · see citing works
Wikstrand, J. (1988) · JAMA · doi:10.1001/jama.259.13.1976 · Cited by 408 · see citing works
Drug Treatment of Hypertension in the Elderly
Insua, J. T., Sacks, H. S., Lau, T.-S., Lau, J., Reitman, D., Pagano, D., & Chalmers, T. C. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-121-5-199409010-00008 · Cited by 233 · see citing works
Microalbuminuria: What Is It? Why Is It Important? What Should Be Done about It?
Bakris, G. L. (2001) · Journal of Clinical Hypertension · doi:10.1111/j.1524-6175.2001.00442.x · Cited by 92 · see citing works
Self-citationPrimary Prevention With Metoprolol in Patients With Hypertension
Staessen, J. A. (1988) · JAMA · doi:10.1001/jama.1988.03410120059015 · Cited by 90 · see citing works
Effect of amlodipine on mode of death among patients with advanced heart failure in the praise trial
O’Connor, C. M., Carson, P. E., Miller, A. B., Pressler, M. L., Belkin, R. N., Neuberg, G. W., Frid, D. J., Cropp, A. B., Anderson, S., WERTHEIMER, J. H., et al. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00496-2 · Cited by 89 · see citing works
Maximizing Cardiorenal Benefit in the Management of Hypertension: Achieve Blood Pressure Goals.
Bakris, G. L. (1999) · PubMed · Cited by 73 · see citing works
Self-citationStaying the Course—With a Few Adjustments
Davidson, M. B. (2002) · Diabetes Care · doi:10.2337/diacare.25.1.1 · Cited by 50 · see citing works
Are β-blockers efficacious as first-line therapy for hypertension in the elderly?
Wink, K. (2003) · Current Hypertension Reports · doi:10.1007/s11906-003-0024-y · Cited by 24 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Immediate Effect of Slow Pace <i>Bhastrika Pranayama</i> on Blood Pressure and Heart Rate
Pramanik, T., Sharma, H. O., Mishra, S., Mishra, A., Prajapati, R., & Singh, S. (2009) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2008.0440 · Cited by 172 · see citing works
Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug
Zeltser, D., Justo, D., Halkin, A., Rosso, R., Ish-Shalom, M., Hochenberg, M., & Viskin, S. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.03.057 · Cited by 147 · see citing works
Hypertension in adolescents: a review of diagnosis and management
Corrado, S. P., & Somers, M. J. G. (2003) · Current Opinion in Pediatrics · doi:10.1097/00008480-200308000-00003 · Cited by 27 · see citing works
Primary Prevention of Coronary Heart Disease in the Elderly
Dornbrook-Lavender, K. A., Pieper, J. A., & Roth, M. T. (2003) · Annals of Pharmacotherapy · doi:10.1345/aph.1d025 · Cited by 23 · see citing works
Enalapril attenuates cardiorenal damage in nitric-oxide-deficient spontaneously hypertensive rats
Pereira, L. M. M., Bezerra, D. G., MACHADO, D. L., & Mandarim‐de‐Lacerda, C. A. (2004) · Clinical Science · doi:10.1042/cs20030268 · Cited by 16 · see citing works
Ramipril for the Prevention and Treatment of Cardiovascular Disease
Vuong, A. D., & Annis, L. G. (2003) · Annals of Pharmacotherapy · doi:10.1345/aph.1c262 · Cited by 14 · see citing works
Hypertensive crises: diagnosis and management in the emergency room.
Migneco, A., Ojetti, V., LORENZO, A. D., Silveri, N. G., & Savi, L. (2004) · PubMed · Cited by 11 · see citing works
Common Medical Illnesses that Affect Anesthesia and Their Anesthetic Management
Agarwal, R., Porter, M. H., & Obeid, G. (2013) · Oral and Maxillofacial Surgery Clinics of North America · doi:10.1016/j.coms.2013.03.001 · Cited by 10 · see citing works
2-Aryl- and 2-amido-benzothiazoles as multifunctional vasodilators on rat artery preparations
Fusi, F., Durante, M., Sgaragli, G., Cường, N. M., Dung, P. T. P., & Nam, N. (2013) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2013.05.034 · Cited by 8 · see citing works
Renal Sympathetic Denervation: MDCT Evaluation of the Renal Arteries
Hutchinson, B. D., Keane, D., & Dodd, J. D. (2013) · American Journal of Roentgenology · doi:10.2214/ajr.12.8560 · Cited by 8 · see citing works
A Practical Approach to Hypertension in the 21st Century
Waybill, M. M., & Waybill, P. N. (2003) · Journal of Vascular and Interventional Radiology · doi:10.1097/01.rvi.0000083253.29749.2f · Cited by 5 · see citing works
Sfairopoulos, D., Bazoukis, G., Sideris, S., Fragakis, N., Letsas, K., Zekios, K., Liu, T., & Korantzopoulos, P. (2025) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.16697 · Cited by 3 · see citing works
Sulaiman, D. M., Al-Shamma, K. J., & Al-Hassani, A. N. (2017) · Iraqi Journal of Pharmaceutical Sciences · doi:10.31351/vol22iss1pp5-17 · Cited by 2 · see citing works
SRILATHA, L., & KUMAR, N. D. P. (2022) · International Journal of Current Pharmaceutical Research · doi:10.22159/ijcpr.2022v14i1.44117 · Cited by 1 · see citing works
Correia, L. C. L., & Rassi, A. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.11.085 · Cited by 1 · see citing works
Ker, J. (2004) · South African Family Practice · doi:10.1080/20786204.2004.10873156
Erbel, R., Möhlenkamp, S., Moebus, S., Lehmann, N., & Jöckel, K. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.02.076
- Authors
- Garg, J., Messerli, A. W., & Bakris, G. L.
- Affiliations
- Rush University Medical Center (US)
- Venue
- Circulation
- Published
- 2002-05-28
- Volume
- 105
- Issue
- 21
- Pages
- 2458-2461
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2167290944
- Cited by
- 17
- References
- 35
- Citations by year
- 2025: 1 · 2022: 1 · 2017: 1 · 2013: 3
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- essential hypertension, antihypertensive therapy, blood pressure control, hypertension screening, target organ damage, retinopathy, JNC VI guidelines, secondary hypertension
- MeSH terms
- Adrenergic beta-Antagonists, Aged, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Blood Pressure, Calcium Channel Blockers, Cardiovascular Diseases, Humans, Hypertension, Kidney Diseases, Life Style, Male, Risk Factors, Practice Guidelines as Topic, Disease Management, Diabetes Complications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
