Hypertension Guideline-Based Plans

Hypertension is a sustained elevation in arterial pressure that increases afterload and, over time, injures the heart, brain, kidneys, retina, and vasculature. The 2025 Hypertension Canada guideline defines hypertension as blood pressure at or above 130/80 mm Hg, a change from the former Canadian diagnostic threshold of 140/90 mm Hg. The diagnostic threshold and the medication threshold are not identical. In Canada, pharmacotherapy is recommended for all adults with blood pressure at or above 140/90 mm Hg, while adults with systolic pressure of 130–139 mm Hg generally require medication when cardiovascular risk is high. Every patient still receives sustained lifestyle intervention. The number alone does not determine urgency. A reading of 190/115 mm Hg without acute target-organ injury is severe hypertension requiring prompt scheduled treatment and close follow-up. The same pressure accompanied by pulmonary edema, encephalopathy, acute kidney injury, acute coronary syndrome, or aortic dissection is a hypertensive emergency requiring monitored parenteral treatment.