New Diagnostic and Treatment Criteria for Hypertension in Adults

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The definition of hypertension was recently changed by the American College of Cardiology – American Heart Association to a systolic arterial pressure of more than 130 mm Hg, a diastolic pressure of more than 80 mm Hg, or both.

New Diagnostic and Treatment Criteria for Hypertension in Adults

Blood-Pressure
Category
Blood Pressure (mmHg) Treatment†
Normal <120 systolic and <80 diastolic Promote good lifestyle habits
Elevated 120-129 systolic and <80 diastolic Promote lifestyle modifications for 3–6 mo before initiating drug therapy
Hypertension ≥130/80 Promote lifestyle modifications and initiate drug therapy, according to degree of blood-pressure elevation and 10-yr ASCVD risk
Stage 1 130–139 systolic or 80–89 diastolic If 10-yr ASCVD risk is <10%, promote lifestyle modifications for 1 month before initiating drug therapy to reach target blood pressure of <120/80 mm Hg; if risk is ≥10%, initiate drug therapy and promote lifestyle modifications
Stage 2 ≥140 systolic or ≥90 diastolic Initiate drug therapy and promote lifestyle modifications

† ASCVD denotes atherosclerotic cardiovascular disease.

 

References:

  1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/ AAPA/ABC/ ACPM/AGS/ APhA/ASH/ ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Hypertension. 2018 Jun;71(6):e136-e139] [published correction appears in Hypertension. 2018 Sep;72(3):e33]. Hypertension. 2018;71(6):1269–1324. [Medline]
  2. Carey RM, Whelton PK; 2017 ACC/AHA Hypertension Guideline Writing Committee. Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Ann Intern Med. 2018;168(5):351–358. [Medline]

 

Created Feb 10, 2020.