Is a blood pressure reading of 144/75 considered hypertension in an adult patient?

Yes, 144/75 mmHg is Stage 2 Hypertension

A blood pressure reading of 144/75 mmHg is classified as Stage 2 hypertension because the systolic pressure of 144 mmHg exceeds the 140 mmHg threshold, and when systolic and diastolic values fall into different categories, the higher category determines the classification. 1, 2

Blood Pressure Classification

According to the 2017 ACC/AHA guidelines, blood pressure is categorized as follows: 1, 2

• Normal: <120/<80 mmHg
• Elevated: 120-129/<80 mmHg
• Stage 1 Hypertension: 130-139/80-89 mmHg
• Stage 2 Hypertension: ≥140/≥90 mmHg

Your systolic reading of 144 mmHg places you firmly in the Stage 2 category, regardless of the diastolic value of 75 mmHg. 1

Important Measurement Considerations

Before confirming this diagnosis, proper measurement technique and repeat readings are essential. The ACC/AHA recommends: 2

• Blood pressure should be based on an average of at least 2 readings obtained on at least 2 separate occasions
• Patients should be seated quietly for at least 5 minutes before measurement, with back supported, feet flat on the floor, and arm supported at heart level
• Out-of-office measurements (home or ambulatory monitoring) are essential to confirm the diagnosis and exclude white coat hypertension

For clinic readings of 140/90 mmHg or higher, home blood pressure monitoring or ambulatory monitoring should be used to confirm the diagnosis before initiating treatment. 2

Clinical Implications and Management

Stage 2 hypertension typically requires both lifestyle modifications AND pharmacological treatment initiated simultaneously. 1 This differs from Stage 1 hypertension, where treatment decisions depend more heavily on cardiovascular risk assessment.

Treatment Approach:

First-line pharmacologic therapy consists of: 3

• Thiazide or thiazide-like diuretics (hydrochlorothiazide or chlorthalidone)
• ACE inhibitors or ARBs (enalapril or candesartan)
• Calcium channel blockers (amlodipine)

Target blood pressure for most adults under 65 years is <130/80 mmHg. 3

Special Consideration for Your Reading:

Your relatively low diastolic pressure (75 mmHg) requires careful medication selection to avoid excessive diastolic lowering, which could compromise coronary perfusion. 1 This is particularly important when initiating antihypertensive therapy, as some medications may lower diastolic pressure more than systolic.

Cardiovascular Risk

Stage 2 hypertension significantly increases your risk of cardiovascular events. Research demonstrates that compared to normal blood pressure, Stage 2 hypertension is associated with: 4

• A 2-fold increased risk of heart failure
• A 52% increased risk of atrial fibrillation
• Substantially elevated risk of stroke and coronary heart disease

A 10 mmHg reduction in systolic blood pressure decreases cardiovascular disease events by approximately 20-30%. 3

Next Steps

You should: 1, 2

1. Confirm the diagnosis with home blood pressure monitoring (take readings twice daily for at least one week)
2. Schedule evaluation for target organ damage, including assessment for left ventricular hypertrophy, renal function, and retinal changes
3. Begin lifestyle modifications immediately (weight loss if overweight, dietary sodium reduction, increased physical activity, limited alcohol)
4. Expect to initiate antihypertensive medication therapy
5. Plan for follow-up within 1 month after starting treatment to assess response

This is not a hypertensive emergency (which requires systolic >180 mmHg or diastolic >120 mmHg with end-organ damage), so immediate hospitalization is not necessary. 5 However, prompt outpatient evaluation and treatment initiation are warranted.