Normal: BP <120/80
Pre-HTN: SBP 120-139 or DPB 80-89
Stage I HTN: SBP 140-159 or DBP 90-99
Stage II HTN: SBP 160-179 or DBP 100-109
Severe HTN: SBP ≥180 mmHg or DBP ≥110 mmHg.
–Severe asymptomatic hypertension (hypertensive urgency) in adults is defined as systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg.
–Severe symptomatic hypertension = Hypertensive emergency. Patients have significantly elevated blood pressure PLUS signs or symptoms of acute, ongoing target-organ damage.
*The difference between hypertensive emergency and urgency is the presence of symptoms of acute end-organ damage, not the blood pressure itself. Both conditions can and have the same BP ranges, the only difference is that one patient has symptoms of end-organ damage. “Hypertensive emergencies can develop in patients with or without preexisting chronic hypertension. Often, the diastolic pressure is ≥120 mmHg, but there is no specific threshold since individuals who develop an acute rise in blood pressure can develop symptoms if the previous pressure was normal (such as in a pregnant woman who develops eclampsia or a young adult who develops acute glomerulonephritis).” UTD
Resistant Hypertension: Resistant HTN is defined as BP that remains above goal despite concurrent use of three antihypertensive agents of different classes, one of which should be a diuretic. Patients whose blood pressure is controlled with four or more medications are considered to have resistant hypertension. Patients with resistant hypertension are more likely than those with controlled hypertension to have a secondary cause, which is usually at least in part reversible. We must look for it. Also, they are at higher risk for adverse cardiovascular events.
References
Am Fam Physician. 2017 Apr 15;95(8):492-500. http://www.aafp.org/afp/2017/0415/p492.html
Pediatric Hypertension edited by Joseph T. Flynn, Julie R. Ingelfinger, Ronald J. Portman, 3rd Edition, Chapter 37, page 558
www.uptodate.com/contents/management-of-severe-asymptomatic-hypertension-hypertensive-urgencies-in-adults
www.uptodate.com/contents/evaluation-and-treatment-of-hypertensive-emergencies-in-adults