Table 1.

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

GuidelineCountry/regionYearLow CVD riskHigh CVD riskaNotes
Stage 1 HTStage 2 HTStage 3 HTStage 1 HTStage 2 HTStage 3 HT
European Society of Hypertension3Europe2013TherapyTherapyTherapyTherapyTherapyTherapyInitiate therapy in low-risk stage 1 HT if lifestyle modification is unsuccessful
Canadian Hypertension Education Program4Canada2013TherapyTherapyTherapyTherapyTherapyTherapyTherapy 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 Excellence12UK2011Lifestyle adviceTherapyTherapyTherapyTherapyTherapyDiagnosis of hypertension is based on a combination of clinic and ambulatory BP readings
National Heart Foundation of Australia11Australia2010Lifestyle adviceLifestyle adviceTherapyTherapyTherapyTherapyTreatment is also recommended in patients with moderate CVD risk (10–15%) and raised BP (>140/90 mmHg)
Latin American Society of Hypertension7Latin America2009TherapyTherapyTherapyTherapyTherapyTherapyTherapy 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 Hypertension9Japan2009TherapyTherapyTherapyTherapyTherapyTherapyTherapy should be initiated in patients with stage 1 HT if raised BP is sustained after a period of lifestyle modification
American Heart Association5,6,13US2006–2014TherapyTherapyTherapyTherapyTherapyTherapyJNC8 suggests patients aged ≥60 years should only be treated if BP is ≥150/90 mmHg
New Zealand Guidelines Group10New Zealand2003Lifestyle adviceLifestyle adviceTherapyTherapyTherapyTherapyTreatment is based solely on CVD risk: those with high CVD risk should receive therapy. Stage 3 HT = ≥170/100 mmHg
WHO/International Society of Hypertension8World2003TherapyTherapyTherapyTherapyTherapyTherapy
  • 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.