High blood pressure (hypertension) guidelines
Many people have what is considered high-normal blood pressure—sometimes called "prehypertension"—according to guidelines published by the Canadian Hypertension Education Program.1
U.S. guidelines are published by the Seventh Report of the Joint National Committee (JNC 7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.2 Both guidelines are used in Canada.
High blood pressure guidelines Blood pressure Classification 140/90 or above High Below 140/90 Normal 130/85 to 139/89 High-normal Key points from the guidelines:
- If you have a blood pressure of 130 to 139 systolic (the upper number in a blood pressure measurement) over 85 to 89 diastolic (lower number), you are considered to have high-normal blood pressure. You need to begin lifestyle changes to lower your risk for stroke, heart disease, and other complications of high blood pressure. Lifestyle changes include losing excess weight, exercising, limiting alcohol, following a heart-healthy diet, cutting back on salt, and quitting smoking. More than 1 out of every 2 people with high-normal blood pressure who do not make lifestyle changes develop high blood pressure within four years.1
- The increase in stroke and heart disease risk begins at blood pressures as low as 115/75 millimetres of mercury (mm Hg) and doubles with each increase of 20 mm Hg systolic blood pressure and 10 mm Hg diastolic. For example, if your blood pressure were to increase from 115/75 mm Hg to 135/85 mm Hg, your risk of stroke and heart attack would double.
- The lifetime risk for high blood pressure is much greater than previously thought. Ninety percent of those who, at age 55, do not have hypertension will eventually develop it.
- If you are older than 50, a systolic blood pressure over 140 mm Hg is a more important risk factor for stroke and heart disease than your diastolic blood pressure.
- Most people who need medicine to control their high blood pressure should take a thiazide-type diuretic either alone or with another hypertension medicine. You may need initial treatment with other classes of medicines—angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, or calcium channel blockers—if you have other conditions, such as diabetes, heart failure, or chronic kidney disease.
- Most people with high blood pressure will need two or more medicines, including a thiazide-type diuretic, to lower their blood pressure to below 140/90 mm Hg, the goal for people with uncomplicated hypertension. If you have other conditions, such as diabetes, or chronic kidney disease, your goal blood pressure is lower: 130/80 mm Hg.
| Author: | Carrie Henley Robin Parks, MS | Last Updated: July 30, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition | |
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