From the Guidelines
Hypertension (HTN) is classified into two main stages based on blood pressure measurements: Stage 1 hypertension, defined as systolic blood pressure of 130-139 mmHg or diastolic blood pressure of 80-89 mmHg, and Stage 2 hypertension, defined as systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg, as per the 2017 American College of Cardiology/American Heart Association hypertension guideline 1. The classification of blood pressure is crucial for determining the risk of cardiovascular disease and for guiding treatment decisions.
- Normal blood pressure is defined as an average systolic blood pressure less than 120 mmHg and an average diastolic blood pressure less than 80 mmHg.
- Elevated blood pressure is defined as an average systolic blood pressure of 120-129 mmHg and an average diastolic blood pressure less than 80 mmHg.
- Stage 1 hypertension is defined as an average systolic blood pressure of 130-139 mmHg or an average diastolic blood pressure of 80-89 mmHg.
- Stage 2 hypertension is defined as an average systolic blood pressure of at least 140 mmHg or an average diastolic blood pressure of at least 90 mmHg. These classifications are based on the latest evidence and guidelines, and are intended to help clinicians determine the most appropriate treatment approach for each patient, with the goal of reducing the risk of cardiovascular events, stroke, kidney disease, and other complications associated with uncontrolled hypertension 1. The use of out-of-office blood pressure measurements, such as ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM), is also recommended to confirm the diagnosis of hypertension and to titrate medication 1. Overall, the accurate classification and management of hypertension are critical for improving patient outcomes and reducing the burden of cardiovascular disease.
From the Research
Stages of Hypertension
The stages of hypertension are defined based on blood pressure levels. According to the studies, the stages are:
- Normal blood pressure: systolic BP < 120 mmHg and diastolic BP < 80 mmHg 2
- Elevated blood pressure: systolic BP 120-129 mmHg and diastolic BP < 80 mmHg 2
- Stage 1 hypertension: systolic BP 130-139 mmHg or diastolic BP 80-89 mmHg 3, 2, 4
- Stage 2 hypertension: systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg 5, 2
Classification of Hypertension Severity
Classification schemes for hypertension are helpful in defining the condition, quantitating risk, estimating prognosis, and guiding management 6. The classification systems are based on blood pressure levels, and some systems also consider the presence of complications or other risk factors.
Blood Pressure Goals
The blood pressure goals for patients with hypertension are: