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🩺 Hypertension Grading & Treatment Initiation

This tool grades office hypertension and, combined with cardiovascular risk, gives the timing of drug initiation and the blood-pressure target per the 2024 Chinese hypertension guideline.

Hypertension Grading & Treatment Initiation

Systolic BP (office) (mmHg)
Diastolic BP (office) (mmHg)
Cardiovascular risk stratification
Comorbid diabetes/CKD/coronary disease
Age ≥ 80 yr

When to use

Use to decide when to start antihypertensives — immediately for Grade 3 or high/very-high risk, after a lifestyle trial otherwise — and to set the BP target by age and comorbidity.

How it works

Grade by BP (1: 140–159/90–99; 2: 160–179/100–109; 3: ≥ 180/110; high-normal 130–139/85–89). High/very-high risk or Grade 3 → start now; moderate → weeks of lifestyle; low → 1–3 months. Target generally < 140/90 (< 130/80 if tolerated or with diabetes/CKD/coronary disease).

Key points

  • High-normal BP is treated with drugs only when cardiovascular risk is high or very high, otherwise with lifestyle alone. (original synthesis · not guideline verbatim)
  • Patients ≥ 80 years are individualized (around < 140/90), starting cautiously to avoid excessive lowering.
  • Diabetes, CKD, or coronary disease tightens the target to < 130/80.

References

Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.

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