Two major authoritative groups have published classification guidelines for High Blood Pressure: The US Joint National Committee (JNC) and the European Society of Hypertension (ESH) along with the European Society of Cardiology (ESC).

Both groups use 140 mm Hg of Systolic Blood Pressure and 90 mm Hg of Diastolic Blood Pressure as the cut off. However there are some major differences in these two classifications as shown below.

JNC -VII Classification of Hypertension

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has introduced a new classification that includes the term “pre hypertension” for those with Blood Pressure ranging from 120–139 mmHg systolic and/or 80–89 mmHg diastolic.

This new designation is intended to identify those individuals in whom early intervention by adoption of healthy lifestyles could reduce Blood Pressure, decrease the rate of progression of Blood Pressure to hypertensive levels with age, or prevent hypertension entirely.

As per the JNC, Pre-hypertension is not a disease category. Rather, it is a designation chosen to identify individuals at high risk of developing High Blood Pressure, so that both patients and clinicians are alerted to this risk and encouraged to intervene and prevent or delay the disease from developing.

Individuals who are pre-hypertensive are not candidates for drug therapy based on their level of BP and should be firmly and unambiguously advised to practice lifestyle modification in order to reduce their risk of developing High Blood Pressure in the future.

Moreover, individuals with pre-hypertension, who also have diabetes or kidney disease, should be considered candidates for appropriate drug therapy if a trial of lifestyle modification fails to reduce their Blood Pressure to 130/80 mmHg or less.

The European Society of Hypertension Classification of High Blood Pressure