Hypertension in adults: diagnosis and management

National Institute for Health and Care Excellence


  • Stage 1 hypertension: clinic blood pressure is 140/90 mmHg or higher and subsequent ambulatory blood pressure monitoring (ABPM) daytime average or home blood pressure monitoring (HBPM) average blood pressure is 135/85 mmHg or higher
  • Stage 2 hypertension: clinic blood pressure is 160/100 mmHg or higher and subsequent ABPM daytime average or HBPM average blood pressure is 150/95 mmHg or higher
  • Severe hypertension: clinic systolic blood pressure is 180 mmHg or higher, or clinic diastolic blood pressure is 110 mmHg or higher

Measuring blood pressure

  • Healthcare professionals taking blood pressure measurements need adequate initial training and should have their performance reviewed periodically
  • Devices for measuring blood pressure must be properly validated, maintained and regularly recalibrated according to manufacturers' instructions
  • If using an automated blood pressure monitoring device, ensure that the device is validated and an appropriate cuff size for the person's arm is used
  • When measuring blood pressure in the clinic or in the home, standardise the environment and provide a relaxed, temperate setting, with the person quiet and seated, and their arm outstretched and supported
  • Palpate the radial or brachial pulse before measuring blood pressure, since automated devices may not measure blood pressure accurately if there is pulse irregularity (for example, due to atrial fibrillation). If pulse irregularity is present, measure blood pressure manually, using direct auscultation over the brachial artery

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