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classification of systemic hypertension
NICE categorise hypertension as (1):
Stage 1 hypertension
Clinic blood pressure ranging from 140/90 mmHg to 159/99 mmHg and subsequent
ABPM daytime average or HBPM average blood pressure ranging from 135/85 mmHg
to 149/94 mmHg.
Stage 2 hypertension
Clinic blood pressure of 160/100 mmHg or higher but less than 180/120 mmHg
and subsequent ABPM daytime average or HBPM average blood pressure of 150/95
mmHg or higher.
Stage 3 or severe hypertension
Clinic systolic blood pressure of 180 mmHg or higher or clinic diastolic blood
pressure of 120 mmHg or higher.
The American college of Cardiology have redefined blood pressure into 4
- SBP <120 mmHg and DBP <80 mmHg
- SBP 120-129 mmHg and DBP <80 mmHg
- stage 1 - SBP 130-139 mmHg or DBP 80-89 mmHg
- stage 2 .- SBP >=140mmHg or DBP >=90mmHg (1)
individuals with SBP and DBP in 2 categories should be designated to the higher
BP category (2).
Isolated Systolic Hypertension
- Isolated systolic hypertension is defined as systolic blood pressure (BP)
>= 140 mm Hg and diastolic BP <90 mm Hg (3)
- *meta analysis of observational studies have reported that elevated BP and
hypertension are associated with increased risk of CVD, ESRD, subclinical
atherosclerosis, and all-cause death. Hence early appreciation of elevated
risk of cardiovascular disease (CVD) can aid in advising patients on lifestyle
modification to lower BP, and to treat with antihypertensive medication to
prevent CVD (2)
- (1) NICE (August
2019). Clinical management of primary hypertension in adults
- (2) Whelton
PK et al. 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: Executive Summary: A Report of the American College of
Cardiology/American Heart Association Task Force on Clinical Practice
Guidelines. Circulation. 2018;138(17):e426-e483.
- (3) Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004- BHS IV. J Hum Hypertens 2004;18: 139-8
Last edited 04/2020