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High Blood Pressure Diagnosis

Diagnosis of high blood pressure is dependent on both your systolic and diastolic blood pressure readings. The diagnosis is based on the average of two or more properly measured, seated blood pressure readings on each of two or more office visits.

high blood pressure diagnosis
High Blood Pressure Diagnosis in Adults*
  • Normal Blood Pressure: systolic < 120 mmHg and diastolic < 80 mmHg
  • Pre Hypertension: systolic = 120-139 mmHg or diastolic = 80-89 mmHg
  • Hypertension (high blood pressure diagnosis): systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg
* Note, the above guidelines are for adults 18 and older who:
  • Are not on medicine for high blood pressure
  • Are not having a short-term serious illness
  • Do not have other conditions such as diabetes and kidney disease

When systolic and diastolic blood pressures fall into different categories, the higher category should be used to diagnose blood pressure level.

High Blood Pressure Stages

Doctors diagnose the severity of your high blood pressure according to the following categories. This is called staging and treatment for your high blood pressure depends on what stage hypertension you have.

  • Stage 1 Hypertension (mild hypertension): systolic = 140-159 mmHg or diastolic = 90-99 mmHg
  • Stage 2 Hypertension (moderate hypertension): systolic = 160-179 mmHg or diastolic = 100-109 mmHg
  • Stage 3 Hypertension (severe hypertension): systolic ≥ 180 mmHg or diastolic ≥ 110 mmHg

There is an exception to the above definition of high blood pressure. A blood pressure of 130/80 or higher is considered high blood pressure in persons with diabetes and chronic kidney disease.


Less than 120

Less than 80







High Blood Pressure

140 or higher

90 or higher

Stage 1



Stage 2



Stage 3

180 or higher

110 or higer

Types of Hypertension

Prehypertension, also called borderline hypertension, is diagnosed when you don’t have high blood pressure now, but are likely to develop it in the future. You can take steps to prevent high blood pressure by adopting a healthy lifestyle. Patients with prehypertension are at increased risk for progression to hypertension; those in the 130–139/80–89 mmHg blood pressure range are at twice the risk to develop hypertension as those with lower values.

Primary Hypertension: Primary hypertension is also known as essential or idiopathic hypertension. Primary hypertension is by far the most common type of hypertension. Roughly 90-95% of all high blood pressure cases are this type. Primary hypertension is diagnosed when there is no known medical condition that is directly identified as the driver behind the high blood pressure. Instead of a single medical conditions, it is thought there are several combined factors that cause primary hypertension.

Secondary Hypertension: Secondary hypertension represents about 5-10% of all hypertension cases. Secondary hypertension is caused directly by an identified medical condition (e.g. kidney, adrenal gland, aorta), or as a result of certain medications and recreational drugs.

Isolated Systolic Hypertension (ISH): Isolated systolic hypertension is diagnosed when the systolic blood pressure is ≥ 140 and the diastolic blood pressure is < 90. ISH is the most common form of high blood pressure for seniors.

White Coat Hypertension: Some people's blood pressure is high only when they visit the doctor's office. This condition is called white coat hypertension. If your doctor suspects this, you may be asked to check and record your blood pressure at home with a home monitor or an ambulaory blood pressure monitor.

Resistant Hypertension: This is diagnosed when blood pressure can not be reduced to below 140/90 mmHg despite a triple drug regimen. Patients with resistant hypertension are often referred to a hypertension specialist and the cause for the resistance is often found and overcome.

Malignant Hypertension is also known as accelerated hypertension. Malignant hypertension is the most severe and rapidly acting type of hypertension. Blood pressure readings are greater than 240/120. If there are no signs of end-organ damage, the term accelerated hypertension is used. If there is end-organ damage, but no intracranial pressure increases, this is called hypertensive emergency. Lastly, if there is end-organ damage and papilledema (due to raised intracranial pressure), the term Malignant hypertension is used. At pressures at or above 240/120, urgent medical treatment is necessary.

Pulmonary arterial hypertension (PAH) is continuous high blood pressure in the pulmonary artery. The average blood pressure in a normal pulmonary artery is about 14 mmHg when the person is resting. In PAH, the average is usually greater than 25 mmHg.

high blood pressure diagnosis

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