Screening for and management of other modifiable CVD risk factors are recommended in adults with Synopsis Many adult patients with hypertension have other CVD risk factors; a list of such modifiable and relatively fixed risk factors is provided in Table 5. Among US adults with hyper- tension between 2009 and 2012, 15.5% were current smok- ers, 49.5% were obese, 63.2% had hypercholesterolemia, 27.2% had DM, and 15.8% had chronic kidney disease (CKD; defined as estimated glomerular filtration rate [eGFR] <60 mL/ and/or urine albumin:creatinine 300 mg/g).S2.4-3 Not only are CVD risk factors common among adults with hypertension, a higher percentage of adults with CVD risk Table 4. BP Measurement Definitions BP Measurement Definition SBP First Korotkoff sound* DBP Fifth Korotkoff sound* Pulse pressure SBP minus DBP Mean arterial pressure DBP plus one third pulse pressure Mid-BP Sum of SBP and DBP, divided by 2 *See Section 4 for a description of Korotkoff sounds. Calculation assumes normal heart rate. BP indicates blood pressure; DBP, diastolic blood pressure; and SBP, systolic blood pressure. Table 5. CVD Risk Factors Common in Patients With Hypertension Modifiable Risk Factors* Relatively Fixed Risk Factors Current cigarette smoking, secondhand smoking CKD Family history Diabetes mellitus Increased age Dyslipidemia/hypercholesterolemia Low socioeconomic/educational status Overweight/obesity Male sex Physical inactivity/low fitness Obstructive sleep apnea Unhealthy diet Psychosocial stress *Factors that can be changed and, if changed, may reduce CVD risk. Factors that are difficult to change (CKD, low socioeconomic/educational status, obstructive sleep apneaS2.4-12 ), cannot be changed (family history, increased age, male sex), or, if changed through the use of current intervention techniques, may not reduce CVD risk (psychosocial stress). CKD indicates chronic kidney disease; and CVD, cardiovascular disease. Whelton et al 2017 High Blood Pressure Clinical Practice Guideline e21 factors have hypertension. 