Pocket Guide to Selected Preventive Services for Adults

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Blood Pressure Classification (BP)
Stage 1 Hypertension

SBP*, mm Hg
140-159

DBP*, mm Hg
or 90-99

Lifestyle Modification
Yes

Without Compelling Indication
Thiazide-type diuretics for most; may consider ACEI, ARB, BB, CCB, or a combination

With Compelling Indications
Drug(s) for the compelling indications ++ other antihypertensive drugs (diuretics, ACEI, ARB, BB, CCB) as needed


*Treatment determined by highest BP category.
+ Initial combined therapy should be used cautiously in those at risk for orthostatic hypotension.
++ Treat patients with chronic kidney disease or diabetes to BP goal of < 130/80 mm Hg.
DBP = diastolic blood pressure; SBP = systolic blood pressure.
Drug abbreviations: ACEI = angiotensin-converting enzyme inhibitor; ARB = angiotensin-receptor blocker; BB = β-Blocker; CCB = calcium channel blocker.
Source: JNC 7, Prevention, Detection, Evaluation and Treatment of High Blood Pressure, NIH, NHLBI Dec 03.
Note: Absence of 10%-20% BP decrease during sleep may indicate increased cardiovascular disease risk.