Enter resting BP readings to categorize clinical hypertension stage.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Initial screening and diagnosis of high blood pressure in adults ≥18 years.
Monitoring efficacy of antihypertensive pharmacological and lifestyle therapy.
Triage for hypertensive urgency or emergency in acute care settings.
Diagnosis Criteria
Diagnosis of hypertension requires an average based on ≥2 readings obtained on ≥2 occasions. Measurements should be taken after 5 minutes of rest, with the arm supported at heart level.
Section 2
Formula & Logic
Staging Logic (AHA/ACC 2017)
Normal
SBP < 120 AND DBP < 80
Elevated
SBP 120–129 AND DBP < 80
Stage 1
SBP 130–139 OR DBP 80–89
Stage 2
SBP ≥ 140 OR DBP ≥ 90
Crisis
SBP > 180 AND/OR DBP > 120
The "Higher Category" Rule
If the systolic and diastolic pressures fall into different categories, the higher category must be used to classify the blood pressure status.
Kidneys: Acute kidney injury or progression of CKD.
Vascular: Aortic dissection.
White Coat vs. Masked Hypertension
Consider ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) for patients with office-only elevations (White Coat) or normal office readings but suspected TOD (Masked).
Section 4
Next Steps
Management Strategy
01
Normal: Recheck annually; healthy lifestyle.
02
Elevated: Lifestyle modification; recheck in 3–6 months.
03
Stage 1: If ASCVD risk ≥ 10% or history of CVD/DM/CKD, start 1 medication. If risk < 10%, lifestyle and recheck.
Crisis: Immediate specialist evaluation. If asymptomatic (urgency), adjust meds. If symptomatic (emergency), admit for IV therapy.
Section 5
Evidence Appraisal
Primary Reference
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.
Whelton PK et al. • Hypertension.. 2018;The landmark guideline that lowered the threshold for Stage 1 Hypertension to 130/80 mmHg based on evidence of increased CVD risk at lower pressures.
The SPRINT Trial
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated that intensive BP control (target < 120 mmHg) significantly reduced cardiovascular events and all-cause mortality compared to standard control (< 140 mmHg).
