New guidelines from the American Heart Association AHA and the American College of Cardiology ACC for detection prevention management and treatment of high blood pressure have redefined high blood pressure for first time in 14 years. The guidelines were presented November 13 2017 at AHA s 2017 Scientific Sessions conference in Anaheim In a change from the older definition of 140 90 and higher high BP is now defined as systolic BP 130 mm Hg and higher or diastolic BP 80 and higher. By lowering the definition of high BP the guidelines recommend earlier intervention to prevent further increases in blood pressure and the complications of hypertension. The importance of using proper technique to measure BP has been emphasized. Blood pressure levels should be based on an average of two to three readings on at least two different occasions. The new guidelines have eliminated the category of prehypertension which was used for blood pressures with a top number systolic between 120 139 mm Hg or a bottom number diastolic between 80 89 mm Hg. People with those readings now will be categorized as having either Elevated 120 129 and less than 80 or Stage I hypertension 130 139 or 80 89 . Previous guidelines classified 140 90 mm Hg as Stage 1 hypertension. This level is classified as Stage 2 hypertension under the new guidelines. High blood pressure should be treated earlier with lifestyle changes and in some patients with medication at 130 80 mm Hg rather than 140 90. Medication for Stage I hypertension should be prescribed if a patient has already had a cardiovascular event such as a heart attack or stroke or is at high risk of heart attack or stroke based on age the presence of diabetes mellitus chronic kidney disease or calculation of atherosclerotic risk. Blood pressure categories in the new guideline are Normal Less than 120 80 mm Hg Elevated Top number systolic between 120 129 and bottom number diastolic less than 80 Stage 1 Systolic between 130 139 or diastolic between 80 89 Stage 2 Systolic at least 140 or diastolic at least 90 mm Hg Hypertensive crisis Top number over 180 and or bottom number over 120 with patients needing prompt changes in medication if there are no other indications of problems or immediate hospitalization if there are signs of organ damage. Source AHA News Release November 13 2017