How is hypertension classified

How is hypertension classified?

The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (Joint National Committee 8), published in 2014, continues to classify hypertension by the degree of blood pressure (BP) elevation. The measurement must be based on the average of at least two seated measurements on each of two or more office visits. For children, hypertension is defined as systolic or diastolic BP greater than the 95th percentile of BP for a given age, height, and gender, on repeat measurement.

Classification for Adults 18 Years or Older with Elevated Blood Pressure

BP CategorySBPDBP
Normal<120 mm Hgand<80 mm Hg
Elevated120–129 mm Hgand<80 mm Hg
Hypertension
Stage 1130–139 mm Hgor80–89 mm Hg
Stage 2140–159 mm Hgor90–99 mm Hg
Stage 3≥160 mm Hgor≥100 mm Hg

BP, Blood pressure; DBP, diastolic blood pressure; SBP, systolic blood pressure.

Classification for Adults 18 Years or Older with Elevated Blood Pressure

Hypertension StageSBPDBP
Prehypertension120–139 mm HgOr 80–89 mm Hg
Stage I140–159 mm HgOr 90–99 mm Hg
Stage II≥160 mm HgOr ≥100 mm Hg

DBP , Diastolic blood pressure; SBP , systolic blood pressure.

While national and international guidelines have largely promoted uniform BP targets for all populations (<140/90 for those younger than 80, <150/90 for those older than 80), there is increasing recognition that “goal” BP is patient and comorbid specific. For those with prior strokes, the range of 125 to 135/70 to 80 is desired, whereas 130 to 135/80 is adequate for those with non-proteinuric kidney disease. Finally, among those at low-to-moderate risk for cardiovascular disease without diabetes, 120 to 125/70 to 80 appears to provide maximal benefit. The 2017 ACC/AHA guidelines define the systolic BP target of <130/80 mm Hg for everyone except those with a <10% 10-year risk for cardiovascular (CV) events where it is still <140/90.

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