- Is Your Blood Pressure Normal?
- Blood Pressure 136/80
- A blood pressure reading of 136/80 indicates Pre-Hypertension or High Normal.
- Blood pressure categories
- Your blood pressure numbers and what they mean
- Which number is more important?
- Why blood pressure is measured in mm Hg
- Taking your pulse versus checking your blood pressure
- Blood Pressure
Is Your Blood Pressure Normal?
Variations in Normal Blood Pressure
Dr. Ogedegbe says to think of a traffic light when you evaluate your blood pressure readings. “Green is anything less than 120/80, yellow is 120-139/80-89, and red is when your blood pressure is 140/90 and above,” Ogedegbe says. People whose systolic blood pressure is 140 mmHg or greater or whose diastolic blood pressure is 90 mmHg or greater are said to be hypertensive, or have high blood pressure.
Everyone’s blood pressure fluctuates, but normal blood pressure means that yours is usually less than 120/80 mmHg. “Before we can say somebody has high blood pressure, we like to see them take their blood pressure on two separate occasions at least a month apart,” says Ogedegbe.
If your blood pressure is high at one visit, your doctor will probably suggest that you come back for another reading or use a home blood pressure monitor to track your blood pressure before diagnosing you as hypertensive.
A high blood pressure reading at a doctor visit could also be due to what health care providers call “white coat hypertension.” Some people have in-office blood pressure readings that are temporarily elevated due to the anxiety of being at the doctor’s.
At the other end of the spectrum is low blood pressure. Ogedegbe says that blood pressure is generally considered to be low when either systolic blood pressure is less than 90 mmHg or diastolic blood pressure is less than 60 mmHg.
If you have low blood pressure and do not have any worrisome symptoms, such as dizziness, headaches, or an abnormal heart rate, it is probably not a concern. But if your blood pressure is severely low — less than 80/50 mmHg — or you experience a sudden drop in blood pressure, consult your health care provider.
Home Blood Pressure Management and Monitoring
Avoiding white coat hypertension is one of the advantages that home blood pressure monitoring has over in-office monitoring. Home monitoring gives your doctor a truer picture of what your blood pressure is in your own environment. Another advantage is that it allows your doctor to take the average of several blood pressure readings, instead of relying on a single reading in the medical office.
To best manage your blood pressure at home, follow these guidelines:
- Ask your doctor what type of blood pressure monitor he or she recommends and have it calibrated against the monitor at your doctor’s office.
- Avoid smoking, drinking caffeinated beverages, or exercising for 30 minutes before you take your blood pressure.
- Relax in a chair with one arm on a table and the other arm at heart level.
- Place the blood pressure cuff over your upper arm (see your device’s instructions for proper placement).
- Take two or three blood pressure readings daily and record your results on a chart, including the date and time of day (it is best to take readings at the same time each day).
- Call your health care provider if you get an at-home reading that is too high or too low.
Knowing your blood pressure is important part of health management, since undiagnosed hypertension puts you at risk for a variety of other conditions. Make sure to consult your doctor if you have any concerns or questions about your blood pressure numbers.
Return to the Hypertension Awareness Center.
The American College of Cardiology and the American Heart Association certainly grabbed the attention of us busy primary care physicians when they released their updated blood pressure guidelines.
The definition of the diagnosis of high blood pressure and the decision-making process surrounding its treatment have traditionally been quite individualized (read: all over the place). Personally, I invite these stricter measures, because they are accompanied by solid research, logistical guidance, and useful management strategies.
However, a whole heck of a lot of people just got pulled into a significant medical diagnosis.
Let’s review what’s new.
A new definition of high blood pressure (hypertension)
(Please note that all numbers refer to mm Hg, or, millimeters of mercury.) The guidelines, in a nutshell, state that normal blood pressure is under 120/80, whereas before normal was under 140/90.
Now, elevated blood pressure (without a diagnosis of hypertension) is systolic blood pressure (the top number) between 120 and 129. That used to be a vague category called “prehypertension.”
Stage 1 high blood pressure (a diagnosis of hypertension) is now between 130 and 139 systolic or between 80 and 89 diastolic (the bottom number).
Stage 2 high blood pressure is now over 140 systolic or 90 diastolic.
The measurements must be obtained from at least two careful readings on at least two different occasions. What does careful mean? The guidelines provide a six-step tutorial on how, exactly, to correctly measure a blood pressure, which, admittedly, is sorely needed. My patients often have their first blood pressure taken immediately after they have rushed in through downtown traffic, as they’re sipping a large caffeinated beverage. While we always knew this could result in a falsely elevated measurement, it is now officially poor clinical technique resulting in an invalid reading.
New recommendations on monitoring blood pressure
The new guidelines also encourage additional monitoring, using a wearable digital monitor that continually takes blood pressure readings as you go about your life, or checked with your own cuff at home. This additional monitoring can help to tease out masked hypertension (when the blood pressure is normal in our office, but high the rest of the time) or white coat hypertension (when the blood pressure is high in our office, but normal the rest of the time). There are clear, helpful directions for setting patients up with a home blood pressure monitor, including a recommendation to give people specific instructions on when not to check blood pressure (within 30 minutes of smoking, drinking coffee, or exercising) and how to take a measurement correctly (seated comfortably, using the correct size cuff). The home blood pressure cuff should first be validated (checked in the office, for accuracy).
If you now have high blood pressure, you may not need meds… yet
The guidelines also outline very clearly when a diet-and-lifestyle approach is the recommended, first-line treatment, and when medications are simply just what you have to do. Thankfully, the decision is largely based on facts and statistics. For the elevated blood pressure category, medications are actually not recommended; rather, a long list of evidence-based, non-drug interventions are. What are these interventions? Things that really work: a diet high in fruits and vegetables (such as the DASH diet, which is naturally high in potassium); decreased salt and bad fats; more activity; weight loss if one is overweight or obese; and no more than two alcoholic drinks per day for men, and one for women. Simply changing what you eat can bring down systolic blood pressure by as much as 11 points, and each additional healthy habit you adopt can bring it down another four to five points.
For people with stage 1 hypertension who don’t have cardiovascular disease and are at low risk for developing it (less than 10% risk of an event within 10 years), lifestyle changes are still the way to go. (Risk is determined using a well-researched, widely used formula available here.)
However, if a patient has any kind of cardiovascular disease and stage 1 hypertension (a blood pressure over 130 systolic or 80 diastolic), or no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years), then lifestyle changes plus medications are recommended. And, even if someone has less than a 10% risk, if their blood pressure is over 140 systolic or 90 diastolic, which is now stage 2 high blood pressure, they ought to be treated with medication as well.
Optimizing treatment of high blood pressure
The authors bring several evidence-based yet progressive concepts into the guidelines, the first of which is that high blood pressure should be treated using a team approach. This makes sense, as science supports more and better patient education around self-monitoring, nutrition, and lifestyle changes, as well as stress management. Telehealth is emphasized as a cost-effective method of ongoing monitoring that is more convenient for patients than frequent office visits.
And why should this all matter to you?
Mountains of research over time have shown a very clear link between high blood pressure and cardiovascular disease. A 20-point higher systolic blood pressure or a 10-point higher diastolic blood pressure is associated with double your risk of death from a heart attack, stroke, or other cardiovascular complication (like abdominal aortic aneurysm or heart failure). What many people don’t realize is that those who survive these events find their lives permanently altered by disability and medical complications.
Much is being made of the fact that the new definitions of high blood pressure will mean roughly half of all US citizens will be considered to have high blood pressure, but when you really look at the numbers, as cardiologists already have, not that many more people will actually be advised to take medications. Although the public has good reason to be suspicious of “big pharma,” that’s not what this is about.
Diet and lifestyle changes are powerful medicine. Even if your blood pressure is normal now, you can help to prevent it from becoming elevated starting today. Eat more fruits, veggies, and whole grains, and limit foods high in sodium and unhealthy fats. Be as physically active as possible.
There is a lot more in the very long, detailed executive summary, including specific guidance for various populations, myriad diseases, and special circumstances, but this is the gist of it. The document is free, and available here.
When you decide to start monitoring your blood pressure at home, you may not know where to begin. Maybe your doctor told you that your blood pressure numbers were concerning and suggested that you monitor at home. Or maybe you do have hypertension and want to track your progress when you start making heart healthy lifestyle choices. No matter your reasons to monitor your blood pressure at home, you may wonder what those numbers on your monitor actually mean.
Track your blood pressure over time.
While taking your blood pressure
Two numbers will appear on your screen, as shown on iHealth’s wireless blood pressure monitor, when taking your blood pressure. The top number is your systolic pressure, which measures the pressure in your arteries as your heart beats. The bottom number is your diastolic, or the pressure in your arteries between heartbeats. These numbers are measured in millimeters of mercury, or mm Hg. Here is how to make sense of your numbers:
- Normal blood pressure: According to the American Heart Association, blood pressure is in the normal range if it’s below 120/80 mm Hg.
- Prehypertension: Between 120/80 mm Hg and 139/89 mm Hg.
- Stage 1 high blood pressure: Between 140/90 mm Hg and 159/99 mm Hg.
- Stage 2 high blood pressure: Between 160/100 mm Hg and 179/109 mm Hg.
- Hypertensive crisis: Above 180/110 mm Hg.
There are a number of factors that cause spikes and dips in blood pressure throughout the day. If your doctor suggests monitoring your blood pressure at home, chances are, he or she has told you to take your blood pressure a couple of times a day to account for these fluctuations. If you’re using a wrist blood pressure monitor, all of your measurements will be saved right on your phone. If you find that your readings are regularly above normal, talk to your doctor about changes you can make to get your blood pressure to a healthy level.
A blood pressure reading of 136/80 indicates Pre-Hypertension or High Normal.
View the full blood pressure chart to learn more about blood pressure readings.
What does a blood pressure reading of 136/80 mean?
Readings between 120/80 and 139/89 indicate Pre-Hypertension or High Normal blood pressure. The good news is you don’t have hypertension. However, your blood pressure is higher than recommended for most adults.
Research suggests that people with pre-hypertension are more likely to have a heart attack or stroke compared to those with lower blood pressure.
What to do if your blood pressure reading is 136/80
A blood pressure reading of 136/80 could be interpreted as warning sign since it’s on the high side of normal.
People with pre-hypertension often develop hypertension, so having your blood pressure checked regularly is important.
As an aside, home blood pressure monitors are amazingly affordable and great way to stay on top of your blood pressure. So invest in your health and check out Amazon’s best rated blood pressure monitors today.
Already on blood pressure medicine? If so, this level of blood pressure may be considered adequate, especially if your systolic (upper number) blood pressure is between 120 and 130.
Medications with Blood Pressure of 136/80
Most doctors don’t prescribe medication to treat pre-hypertension unless the patient has other medical conditions that would benefit from lower blood pressure. Instead, lifestyle changes including diet and exercise are recommended.
Lifestyle Changes with Blood Pressure of 136/80
Lifestyle modifications for those with a blood pressure of 136/80 include the following:
- Stop smoking
- Lose weight
- Increase exercise
- Lower salt intake
- Reduce caffeine
- Limit alcohol
- Alleviate stress
Review your medical plan with a doctor before pursuing lifestyle modifications since each patient may have specific medical conditions that make certain activities dangerous. For instance, your level of physical exercise might be limited by a heart condition.
Blood pressure categories
The five blood pressure ranges as recognized by the American Heart Association are:
Blood pressure numbers of less than 120/80 mm Hg are considered within the normal range. If your results fall into this category, stick with heart-healthy habits like following a balanced diet and getting regular exercise.
Elevated blood pressure is when readings consistently range from 120-129 systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control the condition.
Hypertension Stage 1
Hypertension Stage 1 is when blood pressure consistently ranges from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD), such as heart attack or stroke.
Learn more about your risk with our Check. Change. Control. Calculator™.
Hypertension Stage 2
Hypertension Stage 2 is when blood pressure consistently ranges at 140/90 mm Hg or higher. At this stage of high blood pressure, doctors are likely to prescribe a combination of blood pressure medications and lifestyle changes.
This stage of high blood pressure requires medical attention. If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and then test your blood pressure again. If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis.
If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision or difficulty speaking, do not wait to see if your pressure comes down on its own. Call 911.
Your blood pressure numbers and what they mean
Your blood pressure is recorded as two numbers:
- Systolic blood pressure (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.
- Diastolic blood pressure (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
Which number is more important?
Typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.
However, either an elevated systolic or an elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.
Why blood pressure is measured in mm Hg
The abbreviation mm Hg means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used in medicine today as the standard unit of measurement for pressure.
Taking your pulse versus checking your blood pressure
While both are indications of health, blood pressure and heart rate (pulse) are two separate measurements. Learn more about the difference between blood pressure and heart rate.
What is blood pressure?
Your blood pressure is a measurement of the pressure/force inside your arteries with each heartbeat. Each time your heart beats, blood is pumped out of the heart into arteries that carry the blood throughout your body.
How is blood pressure measured?
A special cuff is used to measure your blood pressure. The cuff inflates and deflates, and during the process, your pressures are measured. Many times, a stethoscope is also used.
Blood pressure readings
Blood pressure is recorded as two measurements: systolic and diastolic blood pressure. Systolic blood pressure is the top/first number, and diastolic blood pressure is the bottom/second number. The numbers are expressed as millimeter of mercury (mmHg)
Systolic blood pressure
The pressure in the arteries when the heart is beating and the arteries are filled with blood
Diastolic blood pressure
The pressure in the arteries when the heart is resting between beats
What do the numbers mean?
Your blood pressure can be normal, elevated, or you may have Stage 1 or 2 hypertension (high blood pressure).
Normal blood pressure is <120/<80 mmHg
Elevated blood pressure is 120-129/<80 mmHg
Stage 1 hypertension is 130-139 (top number) OR 80-89 (bottom number)
Stage 2 hypertension is 140 or higher (top number) OR 90 or higher (bottom number)
Two or more readings are needed to determine if you have high blood pressure.
GET IMMEDIATE MEDICAL ATTENTION!
IF YOUR TOP NUMBER IS EVER 180 OR HIGHER AND/OR YOUR BOTTOM NUMBER IS EVER 110 OR HIGHER, GET EMERGENCY MEDICAL TREATMENT OR HAVE SOMEONE TAKE YOU TO THE HOSPITAL RIGHT AWAY!
Your blood pressure does not stay the same at all times. When you are exercising or excited, your blood pressure goes up. When you are resting, your blood pressure is lower. Your blood pressure can also change due to age, medications you take, and changes in position.
Tips for measuring your blood pressure
- Sit for at least 5 minutes before your blood pressure is measured.
- Do not smoke or drink caffeine 30 minutes before you measure your blood pressure.
- If you are nervous when you go to the doctor, you could have a false high blood pressure reading. This is called “white coat syndrome.” If this happens, your doctor may ask you to: Use a blood pressure monitor to check your blood pressure throughout the day. You can bring a record of your readings to your appointments.
Some people are asked to wear a blood pressure monitor for 24 hours. The monitor is usually set to take blood pressure every 15 to 30 minutes as you go about your normal activities.
What are the symptoms of high blood pressure?
High blood pressure usually has no symptoms. It is often called the “silent killer” because it can damage your heart, kidneys and brain without you even knowing anything is wrong.
Who is at risk of getting high blood pressure?
Your risk of high blood pressure is higher if:
- You have a family history of high blood pressure, cardiovascular disease or diabetes
- You are African American
- You are age 60 or older
- You take oral contraceptives
- You are overweight
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