Hypertension | Guidelines and Management

Hypertension is a life-threatening condition that affects 1.13 billion people worldwide, according to the world health organization (WHO). It’s a leading cause of premature death around the world. Thus, we should know more about it; we will discuss the hypertension guidelines that show the different systems of classification and management.

  • Guidelines are useful to know the best way to evaluate and deal with hypertension cases.

We will discuss guidelines issued by some organizations, including the European society of hypertension (ESH), European society of cardiology (ESC), American college of cardiology (ACC), American Heart Association (AHA), and the Joint National Committee (JNC).

We will discuss the guidelines for hypertension classifications, targeting blood pressure management, hypertensive emergencies, and hypertension in pregnancy.

Guidelines for hypertension classifications

European society of hypertension (ESH), and the European society of cardiology (ESC) issued this classification system:

    • Optimal blood pressure is lower than 120/80 mmHg.
    • Normal blood pressure is between 120/80 mmHg and 129/84 mmHg.
    • High normal blood pressure ranges between 130/85 mmHg and 139/89 mmHg.
    • Grade 1 hypertension ranges between 140/90 mmHg and 159/99 mmHg.
    • Grade 2 hypertension ranges between 160/100 mmHg and 179/109 mmHg.
    • Grade 3 hypertension is 180/110 mmHg or higher.
    • Isolated systolic hypertension can be diagnosed after a systolic blood pressure of 140 mmHg or higher, with a diastolic blood pressure lower than 90 mmHg.

American college of cardiology (ACC) and American heart association (AHA) issued this classification system:

    • Normal blood pressure is lower than 120/80 mmHg.
    • Elevated blood pressure equals 120-129/80 mmHg
    • Stage 1 hypertension ranges between 130/80 mmHg and 139/89 mmHg.
    • Stage 2 hypertension is higher than 140/90 mmHg.
    • Hypertensive crisis occurs when blood pressure is higher than 180/120 mmHg.

According to the 7th report of the joint national committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure:

    • Normal blood pressure is lower than 120/80 mmHg.
    • Prehypertension ranges between 120/80 mmHg and139/89 mmHg.
    • Stage 1 hypertension: It occurs when blood pressure is between 140/90 mmHg and 159/99 mmHg.
    • Stage 2 hypertension is higher than 160/100 mmHg.

This classification is the most used in the United States for adults (≥18 years).

» Now, let’s know the guideline for target blood pressure to know at which level we should keep our blood pressure.