Blood Pressure (BP) Classification

Blood pressure (BP) is a measure of the force of blood pushing against the walls of your arteries. The two numbers in a BP reading represent systolic pressure (the top number) and diastolic pressure (the bottom number).

According to the JNC 7 guidelines, BP is classified as follows:

• Normal: Systolic less than 120 mm Hg and diastolic less than 80 mm Hg
• Prehypertension: Systolic 120-139 mm Hg and diastolic 80-89 mm Hg
• Stage 1: Systolic 140-159 mm Hg and diastolic 90-99 mm Hg
• Stage 2: Systolic 160 mm Hg or greater and diastolic 100 mm Hg or greater

The 2017 ACC/AHA guidelines eliminate the classification of prehypertension and divides it into two levels 

(1) elevated BP, with a systolic pressure (SBP) between 120 and 129 mm Hg and diastolic pressure (DBP) less than 80 mm Hg, and

(2) stage 1 hypertension, with an SBP of 130 to 139 mm Hg or a DBP of 80 to 89 mm Hg.er

Primary vs. Secondary Hypertension

Hypertension can be classified as either primary or secondary.

Primary (essential) hypertension is the most common type and accounts for about 90-95% of cases. The cause of primary hypertension is unknown.

Secondary hypertension is caused by an underlying medical condition, such as kidney disease or sleep apnea.

Hypertensive Crises

Hypertensive crises are severe cases of hypertension with a BP of more than 180/120 mm Hg. They can be further categorized as hypertensive emergencies or urgencies.

• Hypertensive emergencies: Characterized by evidence of impending or progressive target organ dysfunction, such as stroke or heart attack.
• Hypertensive urgencies: Situations without progressive target organ dysfunction.

Treatment of Hypertensive Emergencies

In hypertensive emergencies, BP should be aggressively lowered within minutes to an hour by no more than 25%, and then lowered to 160/100-110 mm Hg within the next 2-6 hours.

Prevention of Hypertension

There are a number of things you can do to prevent or delay the onset of hypertension, including:

• Maintaining a healthy weight
• Eating a healthy diet
• Exercising regularly
• Limiting alcohol intake
• Not smoking

Conclusion

Hypertension is a common condition that can lead to serious health problems if not treated. By knowing your BP numbers and taking steps to control them, you can reduce your risk of complications.