The Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Report recommends using the mean of two or more properly measured seated blood pressure readings, taken on two or more office visits, for establishing of the blood pressure. The blood pressure measurement should be verified in the contralateral arm. This report identifies four levels of systolic and diastolic hypertension, affirmed by the American Society of Hypertension in 2013. Note that either component may be high. In 2013, the Eighth Joint National Committee (JNC 8) issued the JNC 8 report based on rigorous scientific review of clinical trial data. This report focuses more narrowly on thresholds and goals for pharmacologic treatment. For patients ages ≥18 years to <60 years in the general population, JNC 8 recommends treatment to lower blood pressure for a diastolic blood pressure of ≥90 (strong evidence) and systolic blood pressure of ≥140 (expert opinion). For patients ages ≥60 years, JNC 8 recommends treatment for blood pressures ≥150/90. The JNC 8 report also recommends a higher treatment threshold than JNC 7 for patients with diabetes and chronic kidney disease (CKD), ≥140/90.

When the systolic and diastolic levels fall in different categories, use the higher category. For example, 170/92 mm Hg is stage 2 hypertension; 135/98 mm Hg is stage 1 hypertension. In isolated systolic hypertension, systolic blood pressure is ≥140 mm Hg, and diastolic blood pressure is <90 mm Hg.

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