Table 1.

Summary of treatment recommendations for patients with stage 1, 2, and 3 hypertension

Guideline	Country/region	Year	Low CVD risk			High CVD risk^a			Notes

			Stage 1 HT	Stage 2 HT	Stage 3 HT	Stage 1 HT	Stage 2 HT	Stage 3 HT
European Society of Hypertension³	Europe	2013	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy	Initiate therapy in low-risk stage 1 HT if lifestyle modification is unsuccessful
Canadian Hypertension Education Program⁴	Canada	2013	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy should only be initiated if mean BP is raised on three occasions (high risk or stage 2–3 HT) or five occasions (stage 1 HT and low risk)
National Institute for Health and Care Excellence¹²	UK	2011	Lifestyle advice	Therapy	Therapy	Therapy	Therapy	Therapy	Diagnosis of hypertension is based on a combination of clinic and ambulatory BP readings
National Heart Foundation of Australia¹¹	Australia	2010	Lifestyle advice	Lifestyle advice	Therapy	Therapy	Therapy	Therapy	Treatment is also recommended in patients with moderate CVD risk (10–15%) and raised BP (>140/90 mmHg)
Latin American Society of Hypertension⁷	Latin America	2009	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy should only be initiated in patients with stage 1 or 2 HT if raised BP persists for ‘a few weeks’ (in those with moderate CVD risk) or ‘several months’ (in those with low CVD risk)
Japanese Society of Hypertension⁹	Japan	2009	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy should be initiated in patients with stage 1 HT if raised BP is sustained after a period of lifestyle modification
American Heart Association⁵,⁶,¹³	US	2006–2014	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy	JNC8 suggests patients aged ≥60 years should only be treated if BP is ≥150/90 mmHg
New Zealand Guidelines Group¹⁰	New Zealand	2003	Lifestyle advice	Lifestyle advice	Therapy	Therapy	Therapy	Therapy	Treatment is based solely on CVD risk: those with high CVD risk should receive therapy. Stage 3 HT = ≥170/100 mmHg
WHO/International Society of Hypertension⁸	World	2003	Therapy	Therapy	Therapy	Therapy	Therapy	Therapy

↵a Includes estimated CVD risk ≥20%, existing CVD, diabetes, renal disease, and target organ damage. Stage 1 hypertension = 140/90–159/99 mmHg; stage 2 hypertension = 160/100–179/109 mmHg; stage 3 hypertension = ≥180/110 mmHg. BP = blood pressure. CVD = cardiovascular disease. HT = hypertension. JNC8 = Eighth Joint National Committee. WHO = World Health Organization.