ESC 2024 and ACC/AHA 2025 blood pressure categories compared
What is the difference between the ESC 2024 and ACC/AHA blood pressure categories?
The European ESC 2024 and American ACC/AHA 2025 guidelines use different thresholds. ESC 2024 has three categories: non-elevated (below 120/70 mmHg), elevated (systolic 120–139 or diastolic 70–89) and hypertension (from 140/90). ACC/AHA 2025 has four: normal (below 120/80), elevated (systolic 120–129 with diastolic below 80), stage 1 hypertension (130–139 or 80–89) and stage 2 hypertension (from 140/90). Blood Pressure – My Heart lets you choose the guideline that classifies your readings, ACC/AHA 2025, ESC 2024, ESH 2023 or JNC7, and colour-codes every reading by it, so you can follow the one your doctor uses.
The categories side by side
Values are in mmHg. In ESC 2024 a reading is non-elevated only if both values are below the threshold; in both guidelines a higher systolic or diastolic value is enough to move a reading up a category.
| Guideline | Category | Systolic | Diastolic |
|---|---|---|---|
| ESC 2024 | Non-elevated | below 120 | and below 70 |
| ESC 2024 | Elevated | 120–139 | or 70–89 |
| ESC 2024 | Hypertension | 140 or higher | or 90 or higher |
| ACC/AHA 2025 | Normal | below 120 | and below 80 |
| ACC/AHA 2025 | Elevated | 120–129 | and below 80 |
| ACC/AHA 2025 | Stage 1 hypertension | 130–139 | or 80–89 |
| ACC/AHA 2025 | Stage 2 hypertension | 140 or higher | or 90 or higher |
Measurements at home
The ESC 2024 thresholds refer to measurements in the doctor's office. For measurements at home, ESC 2024 uses an average of 135/85 mmHg or higher to confirm hypertension.
The other guidelines in the app
ESH 2023 (European Society of Hypertension) keeps six categories, from optimal (below 120/80) to grade 3 hypertension (from 180/110). JNC7 is the older American scheme, with prehypertension at 120–139/80–89. On a new installation the app starts with ACC/AHA 2025 for phones set to the United States and ESC 2024 in most other countries; you can change it in the settings at any time.
Categories are not a diagnosis
A category describes a reading. Whether you have high blood pressure, and what to do about it, is for your doctor to decide.