The American Heart Association recognizes the following blood pressure ranges:
Normal
Under 120/80 mm Hg, blood pressure is considered normal. Follow a healthy diet and exercise regularly if you have these results.
Elevated
Blood pressure levels that are consistently 120-129 mm Hg systolic and less than 80 mm Hg diastolic indicate elevated blood pressure. If elevated blood pressure is not controlled, it is likely to lead to high blood pressure.
Hypertension Stage 1
A patient with hypertension Stage 1 has a systolic blood pressure of 130-139 or a diastolic blood pressure of 80-89 mm Hg. When you have high blood pressure at this stage, your doctor may prescribe lifestyle changes and additional blood pressure medication, depending on your risk of atherosclerotic cardiovascular disease (ASCVD), such as heart attack or stroke.
Hypertension Stage 2
Stage 2 hypertension occurs when blood pressure consistently exceeds 140/90 mm Hg. A combination of blood pressure medications and lifestyle changes is likely to be prescribed at this stage of high blood pressure.
Hypertensive crisis
Medical attention is required at this stage of high blood pressure. You should wait five minutes before checking your blood pressure again if your readings suddenly exceed 180/120 mm Hg. If your readings are still unusually high, seek medical help immediately. There is a possibility that you are experiencing a hypertensive crisis.
Why difference between Europe and the USA?
A new generation of hypertension guidelines was released in November 2017 by the American College of Cardiology and the American Heart Association, replacing the Joint National Committee reports from 1977 to 2003.
A new document published in August 2018 by the European Society of Cardiology and the European Society of Hypertension updated their own recommendations. There are several aspects of detection, treatment, and prevention of hypertension that are similar in both documents, but there are some sensitive differences that affect diagnostic and therapeutic elements.
Unlike the European guidelines, the American proposals clearly disrupt previous recommendations. A new blood pressure threshold of 130/80 mmHg is used as a definition for hypertension. Treatment initiation and blood pressure goals for treated patients are not only affected by its prevalence, but also by its therapeutic aspects.
US vs Europe
In the European guidelines, hypertension is defined as a BP ≥140/90 mm Hg (Table 1) while the Americans choose a lower threshold of BP ≥130/80 mm Hg. American guidelines classify Stage 1 hypertension as SBP ≥130‐139 mm Hg or DBP ≥80‐89 mm Hg while the Europeans define this as high normal BP (130-139/85-89 mm Hg). ACC/AHA defines Stage 2 hypertension as BP ≥140/90 mm Hg while the Europeans continue to classify this as Stage 1.
