Hypertension is known as the “silent killer”. Hypertension is divided into two main categories:

1. Essential/primary hypertension : Lack of identifiable causative factors for elevated blood pressure is known as essential or primary hypertension.
2. Secondary hypertension : Secondary hypertension, for which there is an identifiable cause.

GUIDELINES FOR THE DENTAL PRACTIONER

1. Reduction of stress and anxiety
2. Effective control of operative and postoperative pain after can minimize blood pressure elevation in the patient with hypertension.
3. Very anxious patients can be given a small dose of diazepam (5 mg) or shorter-acting benzodiazepines, such as oxazepam (30 mg) the night before and 1 hour before the dental appoint
ment.
4. The appointments can be minimized and preferably planned in the morning. Blood pressure should be monitored before and after the administration of local anaesthesia.
5. It is widely recommended that epinephrine containing local anesthetics should be limited to one to three cartridges of 2 % lidocaine with 1:100,000 epinephrine, safely administered to hypertensive patients.
6. Modifications include increased physical activity, reduced salt intake to less than 6 g per day, and limited alcohol intake reduce the chances of hypertension.