In the healthcare realm, policies and guidelines for just about everything are constantly being re-evaluated. One such re-evaluation occurred recently when the American Heart Association (AHA) and the American College of Cardiology (ACA) issued new guidelines on blood pressure. Actually, the “new guidelines” are a re-categorization of blood pressure and the levels which are considered normal and abnormal.
The “target goal” for all adults, regardless of age, sex, or risk factors has been set at 130/80 mm Hg. That means that every adult should strive to get his/her blood pressure at least to the 130/80 level, with the hope of reaching the ideal level of 120/80 mm Hg.
There are now five categories of blood pressure that clearly give patients the information they need to know if they need treatment. The five categories are listed below:
CATEGORIES OF BLOOD PRESSURE:
NORMAL: 120/80 mm Hg
ELEVATED BP: 120/80-129/80 mmHg
STAGE 1 HIGH BP: 130-139/80-89 mm Hg
STAGE 2 HIGH BP: >140/>90 mm Hg
SEVERE HIGH BP: >180/>120 mm Hg
Accurate blood pressure readings are very important so it is recommended patients rely on 2 or more BP readings taken on 2 or more different occasions. Many things affect people’s blood pressure so frequent readings at different times are necessary to establish a pattern and determine if the individual needs treatment.
Home BP monitoring is recommended because it gives a more accurate picture of the patient’s BP than office readings, and “more strongly predicts cardiovascular outcomes.” In other words, blood pressure fluctuates from minute to minute, and high readings may be missed if monitoring is in the office alone. High BP insidiously affects the cardiovascular system so if a patient’s BP is actually higher than recorded, heart attack or stroke may occur unexpectedly.
SUMMARY:
GOAL: systolic BP of at least <130 mm Hg, 120 is more desired; diastolic BP of 80 mm Hg
TAKE HOME POINTS:
1. Systolic BP goal is <130 mm Hg
2. Use regular home monitoring—it’s more accurate.
3. New category is “Severe Hypertension”— >180/>120 mm Hg
4. Lifestyle Modification-diet, exercise, wt. loss, etc.-still the cornerstone of treatment.
Reference: Skolnik N. What PCP’s Need to Know About the New Blood Pressure Guidelines Medscape 2025 October 31.
