Table 2.

Hypertension Definition, Classification, and BP Thresholds

	ESH/ESC 20136	ASH/ISH 20137	JNC 8 20138	CHEP 20149	NICE 201110	AHA/ACC/CDC 201312
Hypertension definition	SBP >140 mm Hg and/or DBP >90 mm Hg	SBP ≥140 mm Hg or DBP ≥90 mm Hg or both on repeated examination	NS	SBP ≥140 mm Hg and/or DBP ≥90 mm Hg	BP ≥140/90 mm Hg + subsequent average daytime ABPM or average HBPM – BP ≥135/85 mm Hg	NS
Definition of “elderly” population	NS	80 years	60 years	80 years	80 years	NS
Threshold for starting treatment in the nonelderly general population	SBP 140–159 mm Hg or DBP 90–99 mm Hg (grade 1 HTN) in patients at low to moderate risk (IIa, B) SBP 160–179 mm Hg or DBP 100–109 mm Hg (grade 2 HTN) and SBP ≥180 mm Hg or DBP ≥110 mm Hg (grade 3 HTN) in patients with any level of CV risk, a few weeks after or simultaneously with initiation of lifestyle changes (I, A)	BP >140/90 mm Hg and lifestyle changes not effective BP ≥160/100 mm Hg (grade 2 HTN), drug treatment should be started immediately Drug treatment can be started immediately in all HTN patients in whom the practitioner believes it is necessary to achieve more rapid control of BP	SBP ≥140 mm Hg, DBP ≥90 (expert opinion, grade E)	SBP ≥160 mm Hg or DBP ≥100, in patients without macrovascular TOD or other CV risk factors (grade A) SBP ≥140 mm Hg and DBP ≥90 mm Hg, in patients with macrovascular target organ damage or other independent CV risk factors (grade A for DBP, grade C for SBP 140–160 mm Hg, grade A for SBP >160 mm Hg)	BP ≥140/90 in patients with ≥1 of the following: TOD, CVD, CKD, DM, 10‐year CV risk ≥20% BP ≥160/100 mm Hg and subsequent average ABPM/HBPM ≥150/95 mm Hg For patients younger than 40 years and stage 1 hypertension with no evidence of TOD, CVD, renal disease, or DM, consider seeking specialist evaluation of secondary causes of hypertension and a more detailed assessment of potential TOD	SBP 140–159 mm Hg or DBP 90–99 mm Hg

ESH/ESC 20136

ASH/ISH 20137

JNC 8 20138

CHEP 20149

NICE 201110

AHA/ACC/CDC 201312

Hypertension definition

SBP >140 mm Hg and/or DBP >90 mm Hg

SBP ≥140 mm Hg or DBP ≥90 mm Hg or both on repeated examination

SBP ≥140 mm Hg and/or DBP ≥90 mm Hg

BP ≥140/90 mm Hg + subsequent average daytime ABPM or average HBPM – BP ≥135/85 mm Hg

Definition of “elderly” population

80 years

60 years

80 years

Threshold for starting treatment in the nonelderly general population

SBP 140–159 mm Hg or DBP 90–99 mm Hg (grade 1 HTN) in patients at low to moderate risk (IIa, B)

SBP 160–179 mm Hg or DBP 100–109 mm Hg (grade 2 HTN) and SBP ≥180 mm Hg or DBP ≥110 mm Hg (grade 3 HTN) in patients with any level of CV risk, a few weeks after or simultaneously with initiation of lifestyle changes (I, A)

BP >140/90 mm Hg and lifestyle changes not effective

BP ≥160/100 mm Hg (grade 2 HTN), drug treatment should be started immediately

Drug treatment can be started immediately in all HTN patients in whom the practitioner believes it is necessary to achieve more rapid control of BP

SBP ≥140 mm Hg, DBP ≥90

(expert opinion, grade E)

SBP ≥160 mm Hg or DBP ≥100, in patients without macrovascular TOD or other CV risk factors (grade A)

SBP ≥140 mm Hg and DBP ≥90 mm Hg, in patients with macrovascular target organ damage or other independent CV risk factors (grade A for DBP, grade C for SBP 140–160 mm Hg, grade A for SBP >160 mm Hg)

BP ≥140/90 in patients with ≥1 of the following: TOD, CVD, CKD, DM, 10‐year CV risk ≥20%

BP ≥160/100 mm Hg and subsequent average ABPM/HBPM ≥150/95 mm Hg

For patients younger than 40 years and stage 1 hypertension with no evidence of TOD, CVD, renal disease, or DM, consider seeking specialist evaluation of secondary causes of hypertension and a more detailed assessment of potential TOD

SBP 140–159 mm Hg or DBP 90–99 mm Hg

Abbreviations: ABPM, ambulatory blood pressure monitoring; BP, blood pressure; CKD, chronic kidney disease; CV, cardiovascular; DBP, diastolic blood pressure; DM, diabetes mellitus; eGFR, estimated glomerular filtration rate; HBPM, home blood pressure monitoring; HTN, hypertension; NS, no statement; SBP, systolic blood pressure; TOD, target organ damage. For ESH/ESC guidelines, the class of recommendation and level of evidence are stated in parentheses. For JNC 8 guidelines, the strength of recommendation and its grade are stated in parentheses.