Criteria: Table 4-2 Criteria for Rating Permanent Impairment Due to Hypertensive Cardiovascular Disease (66)
Hypertension is rated using Chapter 4, The Cardiovascular System: Systemic and Pulmonary Arteries. Section 4.1 Hypertensive Cardiovascular Disease (66-69) states: “The JNC-6 classifies hypertension, or elevated blood pressure, as an elevation of the systolic blood pressure to = 140 mm Hg or diastolic blood pressure to >89 mm Hg on two or more separate readings.1 (See Table 4-1 for the JNC-6 three-stage hypertension classification.) Hypertension, the leading cause of ambulatory office visits in the United States, can produce heart disease, stroke, and renal failure. The economic impact of heart disease and stroke exceeds $29 billion annually in the United States. The prevalence of hypertension and its complications make it a major public health concern, particularly in the Southeast and among African Americans. Hypertensive heart disease includes hypertension, hypertension-associated systolic and diastolic heart failure (HF), hypertension-associated angina, and hypertension-induced left ventricular (LV) hypertrophy. Hypertensive heart disease can be very debilitating and demands aggressive treatment. Preventive treatment strategies may reduce the risk of developing secondary cardiac changes, the symptoms associated with hypertension, and other organ dysfunction.” Section 4.1a Criteria for Rating Permanent Impairment Due to Hypertensive Cardiovascular Disease (66) states “Table 4-2 addresses the impairment classification for hypertensive cardiovascular disease. Cardiovascular complications of hypertension should be established before assigning a diagnosis of hypertensive cardiovascular disease. Because patients with hypertensive cardiovascular disease do not become symptomatic until the very late stages, the impairment classification requires information on the end-organ damage that may occur even in the absence of symptoms.” Ratings are performed according to criteria provided in Table 4-2 Criteria for Rating Permanent Impairment Due to Hypertensive Cardiovascular Disease (66). Factors including the stage of the hypertension, degree of control and end-organ damage. The physician must use judgment is assigning a specific value within the specified range.
