Pathology · patient case question
Using the 2017 ACC/AHA thresholds, this patient's blood pressure of 145/92 mmHg is classified as:
Patient case: Sjögren Syndrome and Blood Pressure Screening
demo: 56-year-old female
chief: “My mouth and eyes are constantly dry.”
history: Rheumatoid arthritis. Positive anti-SSA (Ro) and anti-SSB (La) antibodies.
meds: Hydroxychloroquine
findings: Blood pressure 145/92 mmHg on two readings. Dry, atrophic oral mucosa with a lobulated tongue, generalized gingival recession, marginal gingivitis, and rampant cervical caries. Bilateral parotid enlargement. Extensive interproximal staining.
Show answer and explanation
Correct answer: D. Stage 2 hypertension
- A. Hypertensive crisis is above 180/120 mmHg and requires urgent medical attention.
- B. Stage 1 is 130–139 systolic or 80–89 diastolic. Under the older JNC 7 scheme this reading would have been Stage 1, which is the source of the confusion on this item.
- C. Elevated blood pressure is 120–129 systolic with diastolic under 80.
- D. Correct. Under the 2017 ACC/AHA classification, Stage 2 begins at 140/90 mmHg, so 145/92 falls into Stage 2. Routine dental care may proceed with monitoring and medical referral for management.
Note: Know both frameworks. JNC 7 called 140–159/90–99 Stage 1; the 2017 ACC/AHA guideline lowered the thresholds so that the same reading becomes Stage 2. The recall answer follows ACC/AHA.