Blood Pressure Classification and Management

Classification and Diagnosis

• The American College of Cardiology and American Heart Association recommend classifying a clinic blood pressure of 135/85 mmHg as Stage 1 Hypertension 1
• The 2017 ACC/AHA guideline establishes blood pressure categories, including Stage 1 Hypertension, which is defined as 130-139/80-89 mmHg 1, 2
• For a reading of 135/85 mmHg, both the systolic and diastolic values fall within the Stage 1 Hypertension range 1, 2

Out-of-Office Blood Pressure Equivalence

• The 2017 ACC/AHA guideline recommends confirming office hypertension with out-of-office measurements, with equivalent thresholds for home BP and ambulatory BP 1, 2
• The equivalent threshold for home BP is ≥135/85 mmHg 2

Treatment Implications

• The American College of Cardiology and American Heart Association recommend antihypertensive medication for Stage 1 Hypertension only when certain conditions are present, such as a 10-year ASCVD risk of ≥10%, clinical CVD, chronic kidney disease, or diabetes mellitus 1
• For patients with Stage 1 Hypertension without these conditions, lifestyle modifications alone are recommended initially 1