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High Blood Pressure Treatment Guidelines - Topic Overview

The U.S. National Institutes of Health publishes guidelines for doctors on high blood pressure classification and treatment. The guidelines are called the Seventh Report of the Joint National Committee (JNC 7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.1

If you have high blood pressure, your doctor will give you a blood pressure goal that is based on your health. For example, your goal will depend on whether you have other conditions such as diabetes, heart failure, coronary artery disease, or chronic kidney disease. Be sure you know your blood pressure goal.

Blood pressure classification
Blood pressure Classification
140/90 or aboveHigh
120/80 to 139/89Prehypertension
119/79 or belowNormal

Treatment for high blood pressure

Blood pressure

Treatment

Blood pressure of 120–139 over 80–89 (prehypertension)

Lifestyle changes

High blood pressure of 140–159 over 90–99

Lifestyle changes, possibly medicines

High blood pressure of 160 over 100 or higher

Medicines plus lifestyle changes

High blood pressure plus organ damage or other risk factors for heart disease

Medicines plus serious lifestyle changes and treatment for the other health problems

Secondary high blood pressure

Medicines, treatment of the condition causing your high blood pressure, or both

African Americans

African Americans are more likely to develop high blood pressure and often have more severe high blood pressure than other groups. They also are more likely to have the condition at an earlier age than others. It is not known why they are at greater risk.

African Americans who are sensitive to salt (sodium), who are obese, or who smoke are at even higher risk for high blood pressure. As a result, African Americans with these risk factors tend to have more organ damage, such as kidney disease, heart attack, and enlargement of the heart, which can lead to heart failure (hypertensive heart disease). Lifestyle changes are especially important for this group.

Children

Children who have high blood pressure often continue to have high blood pressure as adults. Children ages 3 and older need to have their blood pressure monitored regularly during routine physical exams.

High blood pressure in children is rare but needs to be evaluated to find treatable causes. When a child has high blood pressure, it is more likely to be from a secondary cause—like a disease—than when an adult has high blood pressure.

High blood pressure in children should be treated with lifestyle changes and medicine if needed. A child with secondary high blood pressure also requires medicine. The risk of secondary high blood pressure is higher in children than in adults.

Older adults

Older adults often have isolated systolic high blood pressure. This problem is sometimes called ISH, for isolated systolic hypertension. In ISH, systolic blood pressure is above 140, but diastolic blood pressure stays lower than 90.

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WebMD Medical Reference from Healthwise

Last Updated: April 05, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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