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Blood Pressure Classification (JNC 7)

BP-cuff
Picmonic
This Picmonic goes over the Seventh Report of the Joint National Committee on the Evaluation of High Blood Pressure also known as JNC 7. To learn the most recent blood pressure classifications, please visit our Blood Pressure Classification (ACC/AHA 2017) Picmonic. Blood pressure, expressed in millimeters of mercury (mmHg), is a measure of how hard the heart is working to maintain end organ perfusion, and can be measured using a blood pressure cuff, or sphygmomanometer. High blood pressure, or hypertension, can increase risk of cardiovascular disease, stroke and other end-organ damage.  Hypertension is one of the most common reasons for office visits and medication use in the United States. To be diagnosed with essential hypertension, a patient must have two readings done at two separate outpatient visits, that are at least two weeks apart.
15 KEY FACTS
CLASSIFICATIONS
Normal
Normal BP-cuff

Routine screening of these patients should be continued at every checkup to ensure that it remains in the normotensive range.

Systolic (< 120)
Heart-squeeze Less-than 120

In normotensive patients, the systolic blood pressure is below 120 mmHg.

Diastolic (< 80)
Dice Less-than 80

In normotensive patients, the diastolic blood pressure is below 80 mmHg.

Prehypertension
Pre-hiker-BP

Patients who have prehypertension have been found to have an increased cardiovascular risk, and are more likely to develop hypertension. These patients should be managed with diet and lifestyle modification, such as alcohol and smoking cessation.

Systolic +20 (120-139)
Heart-squeeze with (20) Dollar-bill

Prehypertensive patients have a systolic blood pressure between 120 and 139 mmHg.

Diastolic +10 (80-89)
Dice with (10) Tin

Prehypertensive patients have a diastolic blood pressure between 80 and 89 mmHg.

Stage 1 Hypertension
Hiker-BP with (1) Wand

Clinical hypertension is broken down into two stages; stage 1 and stage 2. Patients diagnosed with stage 1 hypertension can often be treated with a single agent, such as a thiazide diuretic, calcium channel blocker, ACE inhibitor or ARB.

Systolic +20 (140-159)
Heart-squeeze with (20) Dollar-bill

Patients with stage 1 hypertension have a systolic pressure over 140 mmHg, but less than 159 mmHg.

Diastolic +10 (90-99)
Dice with (10) Tin

Diastolic pressures in stage 1 hypertension are between 90 and 99 mmHg.

Stage 2 Hypertension
Hiker-BP with (2) Tutu

Clinical hypertension is broken down into two stages; stage 1 and stage 2. Patients diagnosed with stage 2 hypertension often require treatment with two or more agents, such as a thiazide diuretic, calcium channel blocker, and ACE inhibitor or ARB.

Systolic + > 20 (160)
Heart-sqeeze Greater-than (20) Dollar-bill

Patients with stage 2 hypertension have a systolic pressure over 160 mmHg.

Diastolic + > 10 (100)
Dice Greater-than (10) Tin

Diastolic pressures in stage 2 hypertension are over 100 mmHg.

Hypertensive Crisis
Hiker-BP Crying-crisis

Patients with a systolic blood pressure over 180 mmHg and diastolic blood pressure over 100 mmHg are considered to have hypertensive urgency if they are asymptomatic, or hypertensive emergency if they are symptomatic and have signs of end-organ damage. These patients require treatment with PO or IV medications, such as nitrates, calcium channel blockers and beta-blockers.

Systolic > 180
Heart-squeeze Greater-than 180

Patients with a systolic blood pressure over 180 mmHg are considered to have hypertensive urgency if they are asymptomatic, or hypertensive emergency if they are symptomatic and have signs of end-organ damage.

Diastolic > 110
Dice Greater-than 110

Patients with a diastolic blood pressure over 110 mmHg are considered to have hypertensive urgency if they are asymptomatic, or hypertensive emergency if symptomatic and have signs of end-organ damage.

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