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The patient is taking antihypertensive medications but has none of the following abnormalities:
(1) abnormal urinalysis or renal function tests;
(2) history of hypertensive cerebrovascular disease;
(3) evidence of left ventricular hypertrophy;
(4) hypertensive vascular abnormalities of the optic fundus, except minimal narrowing of arterioles.
Class 2 Impairment of the Whole Person, 15—29%
The patient has no symptoms and the diastolic pressures are repeatedly in excess of 90mm Hg; and
The patient is taking antihypertensive medication and has any of the following abnormalities:
(1) proteinuria and abnormalities of the urinary sediment, but no impairment of renal function as measured by blood urea nitrogen (BUN) and serum creatinine determinations;
(2) history of hypertensive cerebrovascular damage;
(3) definite hypertensive changes in the retinal arterioles, including crossing defects and old exudates.
Class 3 Impairment of the Whole Person, 30—54% The patient has no symptoms and the diastolic pressure readings are consistently in excess of 90 mm Hg; and The patient is taking antihypertensive medication and has any of the following abnormalities:
(1) diastolic pressure readings usually in excess of 120 mm Hg;
(2) proteinuria or abnormalities in the urinary sediment, with evidence of impaired renal function as measured by elevated BUN and serum creatinine, or by creatinine clearance below 50%;
(3) hypertensive cerebrovascular damage with permanent neurological residual;
(4) left ventricular hypertrophy according to findings of physical examination, ECG, or chest radiograph, but no symptoms, signs, or evidence by chest radiograph of congestive heart failure; or
(5) retinopathy, with definite hypertensive changes in the arterioles, such as “copper or silver wiring,” or A-V crossing changes, with or without hemorrhages and exudates.
Class 4 Impairment of the Whole Person, 55-95%
The patient has a diastolic pressure consistently in excess of 90 mm Hg; and The patient is taking antihypertensive medication and has any two of the following abnormalities:
(1) diastolic pressure readings usually in excess of 120 mm Hg;
(2) proteinuria and abnormalities in the urinary sediment, with impaired renal function and evidence of nitrogen retention as measured by elevated BUN and serum creatinine or by creatinine clearance below 50%;
(3) hypertensive cerebrovasculardamage with permanent neurological deficits;
(4) left ventricular hypertrophy;
(5) retinopathy as manifested by hypertensive changes in the arterioles, retina, or optic nerve;
(6) history of congestive heart failure; or
The patient has left ventricular hypertrophy with the persistence of congestive heart failure despite digitalis and diuretics.
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