JNC 8

BP Category
Normal
Pre-Hypertension
High BP Stage 1
High BP Stage 2
Hypertensive
Crisis

Systolic BP
(mm Hg)
Less than 120
120-139
140-159
160 or higher
Higher than 180

And
Or
Or
Or
Or

Diastolic BP
(mm Hg)
Less than 80
80-89
90-99
100 or higher
Higher than 110

Drug
Related

Systolic: The top number measures the pressure in the arteries when the heart beats,
and is contracting
Diastolic: The bottom number measures the pressure in the arteries between heartbeats,
when the heart muscle is resting and refilling with blood

LIFESTYLE
MODIFICATION

RenoVascular
Disease

Weight Reduction

Thyroid
Disease

AVG. SBP
REDUCTION

Maintain normal
body weight
DASH Eating Plan
Adopt a diet rich in fruit, vegetables,
low fat dairy products with reduced
content of saturated and total fat
Dietary Sodium
Reduce sodium intake to less than
Reduction
100 mmol/day (2.4 g of sodium or 6 g
of sodium chloride)
Aerobic Physical
Regular aerobic physical activity
Activity
At least 30 min/day, or most days
of the week
Moderation of Alcohol Limit alcohol to: <2 drinks/day;
Consumption
Women: <1 drink/day

Thiazide diuretic,
CCB, ACE-I*,
ARB*, or combo

Glucocorticoid
Excess

Aortic
Coarctation

RECOMMENDATION

BP
>140/90:

Primary
Aldosteronism

Chronic
Kidney
Disease

CAUSES OF RESISTANT HYPERTENSION

Improper BP measurement
Excess sodium intake
Inadequate diuretic therapy
Medication (inadequate dose, drug interactions, supplements)
Excess alcohol intake
Identifiable causes of hypertension
DIAGNOSTIC
WORKUP:
- Assess risk factors
and comorbidities
- Assess presence of
target organ
damage
- Conduct history
and physical exam
- Obtain lab tests
(urinalysis, blood
glucose, hematocrit,
lipid panel,
creatinine)
- Obtain EKG

Sleep
Apnea

5-20 mm Hg
8-14 mm Hg

2-8 mm Hg

4-9 mm Hg

2-4 mm Hg

Reinforce
medication and
lifestyle
adherence

*avoid in black patients

BP not
improving:

1) Titrate initial
drug
2) Add new class

3) Titrate inital
drugs to max
dose
4) Add new class

Treat to <140/90 mm Hg, or <150/90 mm Hg in patients >60 years old WITHOUT diabetes or CKD

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This pocket guide is intended for informational use only.
Revised March 2015