Table 8A. JNC 7 Classification of Blood Pressure for Adults >18 Years Old*

Category  Systolic  Blood  Pressure    (mm Hg)    Diastolic  Blood  Pressure    (mm Hg) Normal  <120   and    <80 Prehypertension    120–139   or   80–89 Stage I  140–159   or   90–99 Stage II  >160   or   >100

* These apply to persons not taking antihypertensive drugs and not acutely ill. When systolic and diastolic pressures fall into different categories, the higher category should be selected to classify the individual's BP status.
^† Based on the average >2 readings taken at >2 visits after an initial screening.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, Md: National Institutes of Health, National Heart, Lung, and Blood Institute. 2003; NIH Publication 03-5231.






Table 8B. JNC 7 Classification and Management of Blood Pressure for Adults*

BP Classification SBP* mm Hg DBP* mm Hg Lifestyle  Modification  Initial Drug Therapy Without Compelling Indications With Compelling Indications  Normal <120 And <80 Encourage N/A N/A  Prehypertension   120–139   Or 80–89  Yes No antihypertensive drug indicated. Drug(s) for compelling indications.‡  Stage 1  Hypertension  140–159  Or 90–99 Yes Thiazide-type diuretics for most.† May consider ACEI, ARB, BB, CCB, or combination. Drug(s) for the compelling indications.‡ Other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed.  Stage 2  Hypertension >160 Or >100 Yes Two-drug combination for most (usually thiazide-type diuretic and ACEI or ARB or BB or CCB).

DBP = diastolic blood pressure; SBP = systolic blood pressure.
Drug abbreviations: ACEI = angiotensin converting enzyme inhibitor; ARB = angiotensin receptor blocker; BB = beta-blocker; CCB = calcium channel blocker.
* Treatment determined by highest BP category.
† Initial combined therapy should be used cautiously in those at risk for orthostatic hypotension.
‡ Treat patients with chronic kidney disease or diabetes to BP goal of <130/80 mmHg.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, Md: National Institutes of Health, National Heart, Lung, and Blood Institute. 2003; NIH Publication 03-5231.






Table 8C. JNC 7: Guideline Basis for Compelling Indications for Individual Drug Classes

Compelling Indication Recommended Drugs   Diuretic    BB    ACEI    ARB    CCB   Aldo   ANT   Heart failure •   • •   •  Post-myocardial infarction   • •     •  High coronary disease risk • • •   •    Diabetes • • • • •    Chronic kidney disease     • •      Recurrent stroke prevention   •   •

ACEI = angiotensin converting enzyme inhibitor; ARB = angiotensin receptor blocker; Aldo ANT = aldosterone antagonist; BB = beta blocker; CCB = calcium channel blocker.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, Md: National Institutes of Health, National Heart, Lung, and Blood Institute. 2003; NIH Publication 03-5231.