Hypertension diagnosis criteria and BP measurement

Here’s a clear, up‑to‑date snapshot. Diagnosis thresholds - ACC/AHA (USA, 2017, reaffirmed): Normal <120/80; Elevated 120–129/<80; Hypertension ≥130/80 (Stage 1: 130–139 or 80–89; Stage 2: ≥140 or ≥90). Confirm with out‑of‑office BP when possible. - ESC/ESH (Europe, 2023): Office hypertension ≥140/90. Home average ≥135/85; 24‑h ambulatory ≥130/80 (daytime ≥135/85; night ≥120/70). - NICE (UK, 2023): Clinic ≥140/90 → confirm with ambulatory (daytime average ≥135/85) or home (≥135/85). Why differences? US emphasizes earlier risk reduction at ≥130/80; Europe/UK keep office cut‑off at 140/90 but rely on home/ambulatory confirmation. How to measure (office and home) - Sit quietly 5 minutes; no caffeine/exercise/smoking 30 minutes prior; empty bladder. - Use validated upper‑arm cuff, correct size; arm supported at heart level; back supported; feet flat; no talking. - Take 2 readings 1–2 minutes apart; average them. New device/visit: measure both arms, use higher arm thereafter. - Home BP: morning and evening, 2 readings each time for 7 days; discard day 1, average remaining (diagnostic threshold ≥135/85). - Ambulatory monitoring is best to exclude “white‑coat” and detect “masked” hypertension. This is educational information; your clinician will tailor targets based on age, diabetes, CKD, or ASCVD risk.