Blood Pressure Classification and Management

Classification Based on Current Guidelines

The American College of Cardiology and American Heart Association recommend categorizing blood pressure into four levels: normal (<120/<80 mmHg), elevated (120-129/<80 mmHg), stage 1 hypertension (130-139/80-89 mmHg), and stage 2 hypertension (≥140/≥90 mmHg) 1, 2
When systolic and diastolic blood pressure fall into different categories, the higher category should be used for classification, as stated by the American College of Cardiology 1, 3
A systolic blood pressure of 148 mmHg falls into the stage 2 hypertension category, regardless of the diastolic value, according to the American College of Cardiology 3

The American College of Cardiology recommends that stage 2 hypertension typically requires both lifestyle modifications and pharmacological treatment 1, 3
The American College of Cardiology suggests that low diastolic pressure requires careful consideration when selecting antihypertensive medications to avoid further lowering of diastolic pressure, which could compromise coronary perfusion, although this specific point is from Praxis Medical Insights, a similar recommendation can be found in other sources 3

The American College of Cardiology recommends regular monitoring of blood pressure for patients with stage 2 hypertension 3
The American Academy of Pediatrics and the American College of Cardiology recommend assessment for target organ damage, including evaluation for left ventricular hypertrophy, renal function, and retinal changes 3, 5