The Stages of Hypertension

Hypertension, or high blood pressure, comes in four stages of development, all of which is caused by a number of underlying factors to include chronic stress, obesity, lack of exercise, alcoholism, smoking, and poor nutrition. The stages of hypertension are pre-hypertension, stage 1 hypertension, stage 2 hypertension, and stage 3 hypertension.

Pre-Hypertension

Chronic high blood pressure first begins with pre-hypertension, which is a systolic blood pressure reading of 120 – 139, a diastolic pressure between 80 – 89, or both. The risk of this deadly condition begins climbing at pressures as low as 115/75 mm Hg, doubling at every 20-point increase in systolic pressure and each 10-point increase in diastolic pressure. Lifestyle changes can be recommended as the only treatment if your blood pressure falls into the pre-hypertension category and you do not have any other risk factors.

Stage 1 Hypertension

Stage 1 hypertension is characterized by a systolic blood pressure of 140 – 159, a diastolic pressure between 90 – 99, or both. Like the pre-hypertensive stage, if you don't have any accompanying conditions such as heart disease, diabetes, kidney disease, or a history of stroke, treatment will typically start with lifestyle modifications. However, these modifications will be accompanied with a single medication. Your primary care physician may let you try lifestyle modifications alone for two or three months to see if you may be able to avoid medication altogether, but many people find that they need to take some type of medication in order to bring their blood pressure numbers down to healthy levels. Several drugs may need to be tried to find a combination that works best.

Stage 2 Hypertension

Stage 2 hypertension is characterized by a blood pressure reading of at least 160 mm Hg, a diastolic pressure is at least 100 mm Hg, or both. In addition to lifestyle modifications, you at least two medications may be prescribed. If this course of action fails to bring your blood pressure down to your target level (below 140/90 for most individuals and below 130/80 for those with diabetes or chronic kidney disease), additional drugs may be added to the mix.

Stage 3 Hypertension

Stage 3 hypertension is very serious. This stage is characterized by a blood pressure reading of 180/110 or higher and needs immediate medical attention. The blood pressure shows a persistent elevation (systolic >180mm Hg; diastolic >110mm Hg) with target end organ damage. The damage to the heart may manifest itself in a strain or enlargement of the left ventricle. Kidney damage may show abnormal laboratory value readings that indicate inefficiency. The damage to the eyes could show up as small hemorrhages due to the sustained blood pressure in such small vessels. Stage 3 hypertension is immediately treated with antihypertensive medications.