Definition

Blood pressure is a continuously distributed variable, and the risk of associated cardiovascular disease likewise rises continuously. The point at which blood pressure is defined as hypertension is therefore somewhat arbitrary. Presently finding sustained blood pressure of 140/90 mmHg or above, measured on both arms is generally regarded as diagnostic. Because blood pressure readings in many individuals are highly variable — especially in the office setting — the diagnosis of hypertension should be made only after noting a mean elevation on two or more readings on two or more office visits, unless the elevations are severe or associated with compelling indications such as diabetes mellitus, chronic kidney disease, heart failure, post-myocardial infarction, stroke, and high coronary disease risk.