Blood Pressure Ranges Chart
Blood pressure is recorded as two numbers: systolic (pressure during heartbeats) over diastolic (pressure between heartbeats), measured in millimeters of mercury (mmHg). The American Heart Association classifies blood pressure into five categories that guide treatment decisions. Hypertension is a leading risk factor for heart attack, stroke, kidney disease, and heart failure.
Reference Data
| Category | Systolic (mmHg) | Diastolic (mmHg) | Clinical Significance | Recommended Action |
|---|---|---|---|---|
| Normal | <120 | <80 | Optimal cardiovascular risk; no treatment needed | Maintain healthy lifestyle; recheck annually |
| Elevated | 120–129 | <80 | Increased risk of developing hypertension without intervention | Lifestyle modifications: exercise, DASH diet, sodium reduction, weight management |
| Stage 1 Hypertension | 130–139 | 80–89 | Elevated cardiovascular risk; organ damage may begin | Lifestyle changes + medication if 10-year ASCVD risk >=10% or existing CVD |
| Stage 2 Hypertension | >=140 | >=90 | Significant cardiovascular, renal, and cerebrovascular risk | Lifestyle changes + antihypertensive medication (usually combination therapy) |
| Hypertensive Crisis | >180 | >120 | Risk of acute end-organ damage: stroke, MI, aortic dissection, renal failure | Seek emergency medical care immediately; IV antihypertensives if organ damage present |
| Low (Hypotension) | <90 | <60 | May cause dizziness, fainting; concerning if symptomatic or acute onset | Evaluate cause; treat underlying condition; increase fluids and salt if appropriate |
Source: AHA/ACC Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, 2017 (Whelton et al.); SPRINT Trial, 2015, NEJM.
How to Interpret This Data
The 2017 AHA/ACC blood pressure guidelines lowered the threshold for hypertension from 140/90 to 130/80 mmHg, reclassifying millions of adults as having Stage 1 hypertension. This change was based on evidence from the SPRINT trial showing that treating to a target of <120 mmHg systolic reduced cardiovascular events by 25% and all-cause mortality by 27% compared to a target of <140 mmHg, though with increased risk of hypotension, syncope, and acute kidney injury.
Blood pressure should be measured under standardized conditions: sitting with back supported, feet flat on the floor, arm supported at heart level, after 5 minutes of quiet rest, with no caffeine, exercise, or smoking in the prior 30 minutes. The diagnosis of hypertension requires elevated readings on at least 2 separate occasions. Home blood pressure monitoring (average of morning and evening readings over 7 days) is increasingly recommended and often provides more accurate data than office measurements, as it avoids white-coat hypertension (artificially elevated in clinical settings) and captures masked hypertension (normal in office but elevated at home).
Isolated systolic hypertension (elevated systolic with normal diastolic) is the most common form of hypertension in adults over 50 and is driven primarily by arterial stiffening. In younger adults, elevated diastolic pressure may be the first sign of hypertension. When systolic and diastolic readings fall into different categories, the higher category determines the classification. For example, 145/85 mmHg is classified as Stage 2 Hypertension based on the systolic reading, even though the diastolic falls in the Stage 1 range.
Frequently Asked Questions
What is the most important number in blood pressure — systolic or diastolic?
Both matter, but systolic blood pressure is generally considered more important for cardiovascular risk prediction in adults over 50. The Framingham Heart Study found that systolic pressure is a stronger predictor of heart disease, stroke, and death than diastolic pressure in older adults. In younger adults (under 40), elevated diastolic pressure may be a more significant early warning sign.
Can blood pressure be different in each arm?
A difference of up to 10 mmHg between arms is normal. A consistent difference greater than 10 mmHg may indicate peripheral artery disease, subclavian stenosis, or aortic dissection and should be evaluated by a physician. Blood pressure should be measured in both arms at least once, and subsequent measurements should use the arm with the higher reading.
What time of day is blood pressure highest?
Blood pressure follows a circadian pattern, typically rising in the early morning (6–10 AM), reaching a second peak in the late afternoon, and dropping to its lowest level during sleep (nocturnal dipping). The early morning surge in blood pressure coincides with the peak incidence of heart attacks and strokes. Non-dipping (failure of blood pressure to drop 10–20% during sleep) is associated with increased cardiovascular risk.