What are the guidelines used to classify blood pressure and hypertension?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Based on recommendations of the JNC 7, the classification of BP (expressed in mm Hg) for adults aged 18 years or older is as follows [5] :

  • Normal: systolic lower than 120 mm Hg, diastolic lower than 80 mm Hg

  • Prehypertension: systolic 120-139 mm Hg, diastolic 80-89 mm Hg

  • Stage 1: systolic 140-159 mm Hg, diastolic 90-99 mm Hg

  • Stage 2: systolic 160 mm Hg or greater, diastolic 100 mm Hg or greater

The classification above is based on the average of 2 or more readings taken at each of 2 or more visits after initial screening. [5, 7] Normal BP with respect to cardiovascular risk is less than 120/80 mm Hg. However, unusually low readings should be evaluated for clinical significance.

Note that in 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults by eliminating the classification of prehypertension and dividing it into two levels [1, 2] :

  • Elevated blood pressure with a systolic pressure between 120 and 129 mm Hg and diastolic pressure less than 80 mm Hg

  • Stage 1 hypertension, with a systolic pressure of 130 to 139 mm Hg or a diastolic pressure of 80 to 89 mm Hg


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