High Blood Pressure Treatment Guidelines

Topic Overview

Doctors have more than one set of guidelines they can follow for treatment of high blood pressure.

The guidelines are based on research evidence and expert opinion, and their recommendations differ in slight ways. But the goal of treatment is the same: to lower your risk of health problems that are caused by, or made worse by, high blood pressure.

If you have high blood pressure, you'll work with your doctor to lower it. Your doctor uses a guideline to help make a treatment plan that is right for you. No matter which guideline your doctor uses, your treatment plan can help you lower blood pressure and stay healthy.

Blood pressure classification

An ideal blood pressure for adults is less than 120/80. High blood pressure is 140/90 or higher.^{footnote 1}

**Blood pressure classification**
If the first (systolic) number is:	OR the second (diastolic) number is:	Your blood pressure is:
120 to 139	80 to 89	Borderline-high (prehypertension)
140 to 159	90 to 99	High
160 or more	100 or more	Very high

Blood pressure goals

Your doctor will give you a blood pressure goal. You'll want to try to keep your blood pressure below your goal. Your goal is based on your age and health. Treatment guidelines differ slightly about blood pressure goals for certain groups of people. No matter which guideline your doctor uses, he or she will recommend a goal that is right for you.

If you have a health problem such as diabetes, heart disease, or kidney disease, your goal might be less than 140/90.

If you don't have another health problem, your goal might be based on your age. For example, if you are over 60, your goal might be less than 150/90.

Treatment options

Treatment options that lower blood pressure include lifestyle changes and medicine.

Your options depend on how high your blood pressure is, whether you have other health problems such as diabetes, and whether any organs have already been damaged. Your doctor may also consider how likely you are to develop other diseases, especially heart disease.

**Treatment options**
Blood pressure	Treatment
Prehypertension (120-139 over 80-89)	Lifestyle changes
High blood pressure (140-159 over 90-99)	Lifestyle changes, possibly medicine
Very high blood pressure (160 over 100 or higher)	Medicine plus lifestyle changes

Everyone needs to have a healthy lifestyle, no matter what his or her blood pressure goal is. Lifestyle changes are as important as medicine in lowering blood pressure and lowering the risk for heart attack and stroke. Lifestyle changes include losing weight, eating healthy, being active, limiting sodium and alcohol, and not smoking.

If healthy habits aren't enough to bring your blood pressure down to your goal, you may need to take medicine too. Work with your doctor to decide what is right for you.

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

Decision Points focus on key medical care decisions that are important to many health problems.

High Blood Pressure: Should I Take Medicine?

Related Information

References

Citations
Weber MA, et al. (2013). Clinical practice guidelines for the management of hypertension in the community. Journal of Clinical Hypertension. DOI: 10.1111/jch.12237. Accessed December 19, 2013.
Other Works Consulted
American Diabetes Association (2016). Standards of medical care in diabetes-2016. Diabetes Care, 39(Suppl 1): S1-S112.
Aronow WS, et al. (2011). ACCF/AHA 2011 Expert consensus document on hypertension in the elderly: A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation, 123(21): 2434-2506.
Eckel RH, et al. (2013). 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1.citation. Accessed December 5, 2013.
Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (2011). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics, 128(Suppl 5): S213-S256.
Fleg JL, et al. (2013). Secondary prevention of atherosclerotic cardiovascular disease in older adults: A scientific statement from the American Heart Association. Circulation, published online October 28, 2013. DOI: 10.1161/01.cir.0000436752.99896.22. Accessed November 22, 2013.
Go AS, et al. (2013). An effective approach to high blood pressure control: A scientific advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. DOI: 10.1161/HYP.0000000000000003. Accessed December 30, 2013.
James PA, et al. (2013). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association. DOI: 10.1001/jama.2013.284427. Accessed December 18, 2013.
Rosendorff C, et al. (2015). Treatment of hypertension in patients with coronary artery disease: A scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Circulation, 131(19): e435-e470. DOI: 10.1161/CIR.0000000000000207. Accessed March 31, 2015.
Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458-2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.
Weber MA, et al. (2013). Clinical practice guidelines for the management of hypertension in the community. Journal of Clinical Hypertension. DOI: 10.1111/jch.12237. Accessed December 19, 2013.

Credits

ByHealthwise Staff

Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine

Kathleen Romito, MD - Family Medicine

Martin J. Gabica, MD - Family Medicine

Specialist Medical ReviewerAdam Husney, MD - Family Medicine

Current as ofNovember 3, 2016

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Current as of: November 3, 2016

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & Adam Husney, MD - Family Medicine