What is Stage 2 Hypertension?

Checking a patient’s blood pressure.
Checking a patient’s blood pressure. Robert Llewellyn/Getty Images

If you have stage 2 hypertension, you have moderate to severe high blood pressure. In most cases, if you have stage 2 hypertension, your doctor will want to start you on an anti-hypertension medicine immediately. Stage 2 hypertension also requires more frequent blood pressure checks and a high level of careful monitoring. 

Stage 2 hypertension, also known as late high blood pressure or severe high blood pressure, is generally characterized by a systolic blood pressure value greater than 159 mmHg, or a diastolic blood pressure value of 99 mmHg.

If you think you have stage 2 hypertension, speak to your doctor and seek treatment.

The Two Stages of Hypertension

Which stage your hypertension is at typically refers to the severity of your blood pressure reading. There are two stages: stage 1 and stage 2.

Your doctor will stage your high blood pressure based on your systolic and diastolic numbers. The systolic number is a measurement of your blood pressure while your heart pumps blood, and is the number that appears on the top of the equation. The diastolic number is a blood pressure measurement while your heart rests between beats, and it is the number that appears on the bottom of the equation.

If you have stage 1 hypertension, your systolic pressure will range from 140 to 159 mm Hg and your diastolic pressure 90 to 99 mm Hg. If you have stage 1 hypertension, your doctor may prescribe a blood pressure reducing medication or suggest lifestyle medications.

Treatment for Stage 2 Hypertension

If you have stage 2 hypertension, your doctor may prescribe you one of the following medications: 

  • ACE inhibitors. These allow blood vessels to widen by preventing angiotensin, a hormone, from forming. ACE inhibitors include Prinival or Zestril (lisinopril, Vasotec (enalapril), and Altace (ramipril).
  • Angiotensin II receptor blockers. This medication helps blood vessels relax by blocking the action of angiotensin and allowing blood vessels to relax. Angiotensin II receptor blockers include Cozaar (losartan), Atacand (candesartan) and Diovan (valsartan).
  • Beta blockers. Beta blockers work by blocking certain nerve and hormone signals to the heart and blood vessels to lower blood pressure. Beta blockers include Lopressor or Toprol XL (metoprolol), Tenormin (atenolol), and Corgard (nadolol).
  • Calcium channel blockers. This medication works by preventing calcium from going into heart and blood vessel. Calcium channel blockers include Norvasc  (amlodipine), Cardizem or Dilacor XR (diltiazem) and Adalat CC or Procardia (nifedipine).
  • Renin inhibitors. These work by slowing down the production of renin, which is an enzyme produced by your kidneys that increase blood pressure.

Your physician may also suggest a variety of lifestyle changes. This may include quitting smoking; maintaining a healthy weight; dietary changes such as consuming a diet rich in fruits, vegetables, and low-fat dairy products; and limiting salt.

Your doctor may also ask you to limit your alcohol intake. For most adults, including women and men over the age of 65, this means up to one drink a day.

Men under the age of 65 are allowed up to two drinks per day.

You should also exercise at least 30 minutes per day. This includes walking, jogging, strength training, yoga, or a cardio workout like cycling.  


High Blood Pressure (hypertension). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410.