Unifying Concepts

JNC-VII Classification and management of blood pressure for adults

The classification is based on the average of two or more properly measured, seated blood pressure readings on each of two or more office visits.

BP Classification

SBP* mmHg

DBP* mmHg

Lifestyle Modification

Initial drug therapy

Without Compelling Indication

With Compelling Indications



and <80


No antihypertensive drug indicated.

Drug(s) for compelling indications.



or 80-89


Stage 1



or 90-99


Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination.

Drug(s) for the compelling indications.

Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed.

Stage 2



or >/=100


Two-drug combination for most† (usually thiazide-type diuretic and ACEI or ARB or BB or CCB).

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

Drug abbreviations: ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; BB, beta-blocker; CCB, calcium channel blocker.



  1. Chobaniam AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, and the National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA 2003;289:2560-2572 [Medline]


Created: April 29, 2005

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