Table 4: Comparison of Blood Pressure Targets and time to initiate pharmacologic treatment.
Guidelines |
BP targets |
BP classification |
BP thresholds (mmHg) |
When to initiate Pharmacologic treatment |
|
SBP |
DBP |
|
|||
JNC 7, 2003 |
< 140/90 mmHg |
Normal |
< 120 |
< 80 |
≥ 140 mmHg for 30-59 years |
< 130/80 mmHg for those with diabetes or Chronic Kidney disease |
Prehypertension |
120-139 |
80-89 |
|
|
Stage I hypertension |
140-159 |
90-99 |
|
||
Stage 2 hypertension |
≥ 160 |
≥ 100 |
|
||
JNC 8, 2014 |
< 150/90 mmHg for patients ≥ 60 years |
JNC 8, did not discuss hypertension diagnostic thresholds |
≥140 mmHg for 30-59 years |
||
≥ 150/90 mmHg for 60yrs and older |
|||||
< 140/90 mmHg for patients < 60, diabetes and CKD |
Based on expert opinion for 18-29 years |
||||
ACC/AHA, 2018 |
< 130/80 mm Hg |
Normal |
< 120 |
< 80 |
≥ 140/90 mmHg for low risk (10-yrs CVD risk < 10%) |
Elevated |
120-129 |
< 80 |
|||
Stage 1 hypertension |
130-139 |
80-89 |
≥ 130/ 80 mmHg for all others |
||
Stage 2 hypertension |
≥ 140 |
≥ 90 |
|
||
National NCD guidelines of Ethiopia, 2016 |
< 140/90 mmHg |
Normal |
< 120 |
< 80 |
|
< 150/90 mmHg for patients >75 years |
Pre-hypertension |
120-139 |
80-89 |
≥160/100 mmHg low risk |
|
Stage 1 hypertension |
140-159 |
90-99 |
≥ 140/90 mmHg for high risk |
||
Stage 2 hypertension |
≥ 160 |
≥ 100 |
≥130/80 mmHg for very high risk patients |
||
Severe hypertension |
≥ 180 |
≥ 110 |
|||
HEARTs package for CVDs, 2018 |
< 140/90 mmHg |
Normal |
< 120 |
< 80 |
|
< 130/80 mmHg for patients with High risk of CVDs and diabetic patients |
Prehypertension |
120-139 |
80-89 |
≥ 140/90 mmHg |
|
Stage I hypertension |
140-159 |
90-99 |
≥ 130/80 mmHg for high risk (CHD, Cerebrovascular disease) |
||
Stage 2 hypertension |
≥ 160 |
≥ 100 |
|
||
Hypertension Canada, 2017 |
< 120/ 80 mmHg, High risk |
Normal |
< 120 |
< 80 |
≥ 120/ 80 mmHg for High risk |
< 130/80 mmHg, diabetics |
Elevated |
120-129 |
< 80 |
≥ 130/80 mmHg for diabetics |
|
< 140/90 mmHg for others |
Stage 1 hypertension |
130-139 |
80-89 |
≥140/90 mmHg, Moderate risk |
|
Stage 2 hypertension |
≥ 140 |
≥ 90 |
≥160/100 mmHg, low risk |
||
Hypertension guideline Australia, 2016 |
< 120/ 80 mmHg, High risk |
Optimal |
< 120 |
< 80 |
|
Normal |
120-129 |
80-84 |
≥ 120/ 80 mmHg, High risk |
||
High normal |
130-139 |
85-89 |
≥140/90 mmHg, Moderate risk |
||
< 140/90 mmHg for others |
Grade 1 (Mild) |
140-159 |
90-99 |
≥160/100 mmHg, low risk |
|
Grade 2 (Moderate) |
160-179 |
100-109 |
|
||
Grade 3 (Severe) |
≥ 180 |
≥ 110 |
|
||
Isolated systolic |
> 140 |
< 90 |
|
||
ESC/ESHGuidelines, 2018 |
< 140/90 mmHg in all patients, if tolerable < 130/80 mmHg |
Optimal |
< 120 |
<80 |
130-139/80-89 mmHg, Consider in very high risk |
Normal |
120–129 |
80-84 |
|||
High normal |
130–139 |
85-89 |
140-159/90-99mmHg, immediately start in very high risk and 3-6 months lifestyle intervention for low risk |
||
120-129/< 80 mmHg in < 65 years |
Grade 1 Hypertension |
140–159 |
90-99 |
||
Grade 2 Hypertension |
160–179 |
100-109 |
|||
130-139/< 80 mmHg in ≥ 65 years |
Grade 3 Hypertension |
≥ 180 |
≥ 110 |
≥ 160/100, immediately start and aim to control BP in 3 months |
|
Isolated Systolic Hypertension |
≥ 140 |
< 90 |
BP indicates blood pressure (based on an average of ≥ 2 careful readings obtained on ≥ 2 occasions). Patients with SBP and DBP in two different categories should be classified in the higher category. BP: Blood Pressure; TIA: Transient Ischemic Attack; Low risk: no CVD or CV risk factors or absolute CVD 5 year risk < 5% ; Moderate risk: absolute 5 year CVD risk, 10-15%; High Risk 10-year CVD risk 20-30% and Very high risk 10-year CVD risk > 30%.