From the Guidelines
Hypertension is classified into several categories based on blood pressure readings, with the most recent and highest quality study suggesting that normal blood pressure is below 120/80 mmHg, elevated blood pressure ranges from 120-129 systolic with diastolic below 80 mmHg, stage 1 hypertension is defined as 130-139 systolic or 80-89 diastolic mmHg, and stage 2 hypertension is 140/90 mmHg or higher 1.
Classification of Hypertension
The classification of hypertension is based on the average of at least two careful readings obtained on at least two separate occasions. The categories of blood pressure are:
- Normal: less than 120/80 mmHg
- Elevated: 120-129 systolic with diastolic below 80 mmHg
- Stage 1 hypertension: 130-139 systolic or 80-89 diastolic mmHg
- Stage 2 hypertension: 140/90 mmHg or higher
Importance of Classification
Proper classification of hypertension is essential to determine the appropriate treatment strategies, which may include lifestyle modifications for milder cases and pharmacological interventions for more severe hypertension. The classification also helps to identify individuals at high risk of cardiovascular disease and to monitor the effectiveness of treatment.
Key Considerations
- Individuals with systolic and diastolic blood pressure in two categories should be designated to the higher blood pressure category 1.
- The use of out-of-office blood pressure measurements, such as ambulatory blood pressure monitoring or home blood pressure monitoring, is recommended to confirm the diagnosis of hypertension and to monitor the effectiveness of treatment 1.
- The classification of hypertension should take into account the presence of underlying conditions, such as kidney disease or adrenal disorders, which may affect blood pressure readings 1.
Recent Guidelines
The most recent guidelines for the classification of hypertension were published in 2022 by the American College of Cardiology and the American Heart Association, which recommend the use of the categories listed above 1. These guidelines also emphasize the importance of lifestyle modifications, such as weight loss, physical activity, and dietary changes, in the management of hypertension.
From the Research
Classification of Hypertension
- Hypertension is a common condition that affects an estimated 122 million people worldwide, and is the leading risk factor for cardiovascular disease and death 2.
- The primary goal in the treatment of hypertension is to reduce overall blood pressure to below 140/90 mmHg, with a more optimal goal of 130/80 mmHg 2.
- Hypertension can be classified into different stages, including stage 1 hypertension, which is characterized by mild increases in systolic and diastolic blood pressure 2.
- The classification of hypertension is based on the level of blood pressure, with higher levels indicating more severe hypertension 3.
Treatment of Hypertension
- Common medications for treating hypertension include calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and diuretics 2.
- CCBs are one of the most widely studied agents and are generally recommended as first-line therapy alone and in combination therapies 2.
- Combination therapy with CCBs and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors has been shown to be an effective dual therapy based on recent meta-analyses 2, 4.
- The choice of treatment depends on the individual patient's needs and medical history, as well as the severity of their hypertension 5, 6.
Stages of Hypertension
- Stage 1 hypertension is characterized by a systolic blood pressure of 130-139 mmHg or a diastolic blood pressure of 80-89 mmHg 3.
- Resistant hypertension is defined as blood pressure that remains above target despite the use of multiple antihypertensive medications 4.
- The classification of hypertension into different stages is important for guiding treatment and preventing cardiovascular complications 3.