Blood Pressure Categories

The AHA recommends BP screening occur starting at age 20, unless a medical condition or other variables such as obesity would require a patient younger than 20 years of age be screened and monitored. BP readings defined by the AHA include normal, elevated (formerly prehypertension), two stages of hypertension, and hypertensive crisis.

Elevated (formally prehypertension) is a designation meant to alert patients of the need to intervene and prevent hypertension. Patients in this designation have increasing health risks and need to make lifestyle changes to return to a normal reading. If changes are not made, prehypertension may progress into hypertension – a serious health risk. Dental and medical providers should reassess BP at future appointments.

Treatment options for Stage 1 hypertension may require prescription medications based on their risk of atherosclerotic cardiovascular disease (ASCVD), e.g., heart attack or stroke. For Stage 2, medical providers are likely to prescribe a combination of blood pressure medication and lifestyle changes. With both stages of hypertension, dental providers should refer to the patient’s source of case (medical provider).

The stage of hypertension that requires immediate medical attention is hypertensive crisis, where BP readings exceeds 180/120. If the patient has these readings, let the patient rest and test again. While the patient rests, check to see if your patient is experiencing any of the following: chest pain, shortness of breath, back pain, numbness or weakness, change in vision or difficulty speaking. If they are, contact 911 immediately.

Blood Pressure Category Systolic mm Hg Diastolic mm Hg
Normal Less than 120 and Less than 80
Elevated (formerly prehypertension) 120–129 and Less than 80
High Blood Pressure (Hypertension)
Stage 1
130–139 or 80–89
High Blood Pressure (Hypertension)
Stage 2
140 or higher or 90 or higher
Hypertensive Crisis Higher than180 and/or Higher than 120
Source: American Heart Association 2017