2018 ESC/ESH Classification of Arterial Hypertension

The relationship between BP and cardiovascular (CV) and renal events is continuous, making the distinction between normotension and hypertension, based on cut-off BP values, somewhat arbitrary. However, in practice, cut-off BP values are used for pragmatic reasons to simplify the diagnosis and decisions about treatment.

 

Classification of office blood pressure¹ and definitions of hypertension grade

Category Systolic (mmHg) Diastolic (mmHg)
Optimal <120 and <80
Normal 120–129 and/or 80–84
High normal 130–139 and/or 85–89
Grade 1 hypertension 140–159 and/or 90–99
Grade 2 hypertension 160–179 and/or 100–109
Grade 3 hypertension ≥180 and/or ≥110
Isolated systolic hypertension² ≥140 and <90

BP = blood pressure; SBP = systolic blood pressure.
¹ BP category is defined according to seated clinic BP and by the highest level of BP, whether systolic or diastolic.
² Isolated systolic hypertension is graded 1, 2, or 3 according to systolic BP values in the ranges indicated.
The same classification is used for all ages from 16 years.

 

References:

  1. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; Authors/Task Force Members. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018 Oct;36(10):1953-2041. [Medline]
  2. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. [Medline]

 

Created Oct 11, 2018.

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