Heart Health

Blood pressure 140/90 or above

At or above 140/90? Yes

Recommendationstandard-threshold-metNo one has reached this rule yet

Start medication

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Strongly recommended

    Starting antihypertensive medication is recommended, alongside lifestyle measures.

    Your reading (146/92 mmHg) is at or above the general drug-therapy threshold of 140/90 mmHg.

    2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults · Class I

  • How to measure it properly

    Before acting on this: one reading isn't a diagnosis. Check it at home, twice a day for a week, and bring the average.

    Blood pressure is diagnosed on an average of several readings across separate occasions, not a single number. Technique matters more than people expect: sit with your back supported and feet flat for five minutes first, arm resting at heart height, cuff on bare skin and correctly sized, no talking, no coffee or exercise in the prior 30 minutes. Take two readings a minute apart, morning and evening. Roughly 1 in 5 people who look hypertensive in a clinic are normal at home (white-coat), and some people with normal clinic readings are high at home (masked) — both change the decision.

    2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults · Class I — measurement method

Beyond current guidelines

Promising evidence that hasn't become standard care yet — worth knowing, not yet worth expecting.

An example person who reaches it

Stage 2 blood pressure, lower-risk” — an illustrative profile, not a real user.

42-year-old womanBP 146/92LDL 12010-yr PREVENT-ASCVD 1.3%

Their path through blood pressure

  1. Below 130/80 mmHg?No
  2. Diabetes (incl. by A1c), known CVD, CKD (low eGFR or albuminuria), or 10-yr PREVENT-CVD ≥7.5%?No — standard threshold applies (140/90)
  3. At or above 140/90?Yes ← this rule

Where it sits

Asked after: Standard-risk group for blood pressure

Sources

Cited by the recommendations above.

Review this rule

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Runs in lib/engine/bpPathway.ts as standard-threshold-met.