Skip to main content

Table 1 Comparison of recommendations for diagnostic and treatment thresholds between NICE, ESH, JNC and CHEP guidelines

From: What is the evidence base for diagnosing hypertension and for subsequent blood pressure treatment targets in the prevention of cardiovascular disease?

Organisation Year Diagnostic threshold Treatment threshold
UK National Institute for Health and Care Excellence (NICE) 2011 OBPM diagnostic threshold: ≥140/90 mmHg (ABPM/HBPM diagnostic threshold: ≥135/85 mmHg) All patients under 80 yrs: OBPM < 140/90 mmHg (ABPM/HBPM: <135/85 mmHg)
OBPM Stage 2 Hypertension ≥160/100 mmHg (ABPM/HBPM: ≥150/95 mmHg) Diabetes : OBPM <140/80 mmHg (or <130/80 mmHg if complications present)
Older ≥80 yrs: OBPM <150/90 mmHg (ABPM/HBPM <145/85 mmHg)
European Society of Hypertension (ESH) 2013 OBPM: ≥140 and/or ≥90 All patients under 80 yrs OBPM <140/90 mmHg
(ABPM Daytime (or awake): ≥135 and/or ≥85 mmHg, ABPM Night-time (or asleep): ≥120 and/or ≥70 mmHg, ABPM 24-h: ≥130 and/or ≥80 mmHg, HBPM: ≥135 and/or ≥85 mmHg) Diabetes: OBPM <140/85 mmHg
High Risk Patients: OBPM <130/80 mmHg
Older ≥80 yrs: OBPM <150/90 mmHg
Joint National Committee on Prevention, Detection, Evaluation and Treatment of Blood Pressure (JNC 7) 2004 Stage 1 hypertension diagnosis should be confirmed within 2 months after initial elevated OBPM ≥140/90 mmHg Non-diabetic patients: OBPM <140/90 mmHg
Diabetic/CKD patients: OBPM <130/80 mmHg
Stage 2 hypertension should be confirmed within 1 m
≥180/110 mm Hg evaluate and treat immediately
(ABPM Daytime (or awake): ≥135/85 mmHg, ABPM Night-time (or asleep): ≥120/75 mmHg)
Routine blood pressure measurements should be taken
− at least once every 2 years for adults with <120/80 mmHg
− every year for adults with 120-139/80-89 mmHg
Joint National Committee on Prevention, Detection, Evaluation and Treatment of Blood Pressure (JNC 8) 2014 • Guidelines did not address diagnostic thresholds of hypertension. Age <60 yrs: OBPM <140/90 mmHg
Diabetes No CKD: OBPM <140/90 mmHg
• The supplementary material recommends averaging 2–3 measurements at each visit to establish a diagnosis of hypertension. CKD present with or without diabetes: OBPM <140/90 mmHg
Older ≥60 years: OBPM <150/90 mmHg
• Thresholds for pharmacological treatment were defined.
• HBPM and ABPM were not included.
Canadian Hypertension Education Program (CHEP) 2015 ABPM Daytime (or awake): ≥135/85 mmHg All ages <80 yrs: OBPM <140/90 mmHg
ABPM 24-h: ≥130/80 mmHg Diabetes: OBPM <130/80 mmHg
HBPM diagnostic threshold: ≥135/85 mmHg) Older ≥80 yrs: OBPM <150 mmHg
OBPM diagnostic threshold:
≥140/90 mmHg averaged across two visits;
≥160/110 mmHg averaged across three visits;
or if ≥140/90 mmHg averaged across five visits
  1. Abbreviations: OBPM office blood pressure measurement, ABPM ambulatory blood pressure measurement, HBPM home blood pressure measurement, CKD chronic kidney disease