Your Blood Pressure Numbers And What They Mean
Your blood pressure is recorded as two numbers:
- Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls when the heart beats.
- Diastolic blood pressure indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
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Which Blood Pressure Number Is Important
Q.When I am monitoring my blood pressure, which number is most important top, bottom, or both?
A. While both numbers in a blood pressure reading are essential for diagnosing and treating high blood pressure, doctors primarily focus on the top number, also known as systolic pressure.
Systolic pressure reflects the force produced by the heart when it pumps blood out to the body, while diastolic blood pressure is the pressure in your blood vessels when the heart is at rest.
Over the years, research has found that both numbers are equally important in monitoring heart health. However, most studies show a greater risk of stroke and heart disease related to higher systolic pressures compared with elevated diastolic pressures. That’s especially true in people ages 50 and older, which is why doctors tend to monitor the top number more closely. The reason for the difference in risk may be related to the force put on the arteries when blood rushes out of the heart.
The American Heart Association now defines high blood pressure as 130/80 mm Hg or higher. The new guidelines recommend you check your blood pressure often, ideally with a home monitor, to help your doctor determine if you need to make lifestyle changes, begin medication, or alter your current therapy.
by Howard LeWine, M.D.
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What Is Systolic Blood Pressure
During a heartbeat, the heart is pushing blood out into the arteries. Doctors call this “systole,” and that’s why it’s called the systolic blood pressure. It’s the pressure during a heartbeat and the highest pressure measured.
When the reading is 120 mmHg or a little below while a person is sitting quietly at rest, the systolic blood pressure is considered normal.
Signs And Symptoms Of Hypertension
Often, kids and teens with pre-hypertension or stage 1 hypertension wont show any symptoms at all. If your child has stage 2 hypertension, she might experience one or more of the following symptoms:
- headaches
- abdominal pain
- breathing problems
An infant with stage 2 hypertension may seem irritable, not be feeding properly, or vomiting. Sometimes these infants are diagnosed with failure to thrive.
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Healthy And Unhealthy Blood Pressure Ranges
Learn whats considered normal, as recommended by the American Heart Association.
| SYSTOLIC mm Hg | and/or | DIASTOLIC mm Hg | |
|---|---|---|---|
| NORMAL | |||
| HIGH BLOOD PRESSURE STAGE 1 | 130 139 | ||
| HIGH BLOOD PRESSURE STAGE 2 | 140 OR HIGHER | ||
| HYPERTENSIVE CRISIS | HIGHER THAN 180 | and/or | HIGHER THAN 120 |
Note: A diagnosis of high blood pressure must be confirmed with a medical professional. A doctor should also evaluate any unusually low blood pressure readings.
The ‘bottom’ Blood Pressure Number Matters Too
HealthDay Reporter
THURSDAY, July 18, 2019 — When it comes to blood pressure readings, the “top” number seems to grab all the attention.
But a large, new study confirms that both numbers are, in fact, critical in determining the risk of heart attack and stroke.
Blood pressure measurements are given as a “top” and “bottom” number. The first reflects systolic blood pressure, the amount of pressure in the arteries as the heart contracts. The second reflects diastolic blood pressure, the pressure in the arteries between heart muscle contractions.
For years, systolic blood pressure has been seen as the one that really matters. That’s based on studies — including the famous Framingham Heart Study — showing that high systolic blood pressure is a stronger predictor of heart disease and stroke.
At the same time, though, doctors measure both systolic and diastolic blood pressure, and treatment guidelines are based on both. So just how important is that diastolic number?
“The idea behind this new study was to address the confusion,” said lead researcher Dr. Alexander Flint, an investigator with Kaiser Permanente Northern California’s division of research.
Using medical records from 1.3 million patients, his team confirmed that, yes, high systolic blood pressure was a stronger risk factor for heart attack and stroke. But those risks also climbed in tandem with diastolic pressure and people with normal systolic readings were still at risk if their diastolic pressure was high.
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What If Lifestyle Changes Dont Help Lower My Blood Pressure
If diet, exercise and other lifestyle changes dont work to lower your blood pressure, your healthcare provider prescribe hypertension medications. Your provider will take into account these drugs effect on other conditions you may have, such as heart or kidney disease, and other drugs youre taking.
You might need to take hypertension medicine from now on. Be sure to follow your providers dosing directions exactly.
Last reviewed by a Cleveland Clinic medical professional on 03/20/2020.
References
What Do Blood Pressure Readings Mean
Blood pressure is measure in millimeters of mercury and recorded as two numbers, systolic and diastolic. Systolic is the top number , which measure the pressure in the arteries when the heart beats, so when its muscles contract. Diastolic the bottom number , which measures the pressure in the arteries between heart beats, so when the muscles relax and refill with blood.
The blood pressure chart reflects the categories defined by the American Heart Association. A normal blood pressure is less than 120/80. If your blood pressure numbers are between 120/80 and 139/89, you have pre-hypertension, which means that you are likely to develop high blood pressure. If your blood pressure numbers are 140/90 or above, you have high blood pressure. For instance, if your systolic blood pressure is between 140 and 159, and your diastolic blood pressure is between 90 and 99, you have Stage 1 Hypertension. You have Stage 2 Hypertension if your systolic blood pressure is over 160 and you diastolic blood pressure is over 100. If your numbers are higher than that, you are in hypertensive crisis and need emergency care.
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Which Number Is More Important
Typically, more attention is given to systolic blood pressure 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.
Low Systolic Blood Pressure
If the systolic blood pressure is lower than normal, it’s called hypotension. If this low blood pressure is serious enough, it can cause lightheadedness, dizziness, or fainting. If it lasts long enough and it isn’t treated, it may cause organs like your kidneys to start shutting down.
Systolic hypotension can occur if the amount of blood in your body becomes too low. This can happen if you are severely dehydrated or you have major bleeding there just isn’t enough blood to push through the body.
It also may happen if the heart muscle is too weak to push blood normally, as in cases of cardiomyopathy or if the arteries suddenly widen too much, as in vasovagal syncope .
Sometimes this low blood pressure happens when you change positions suddenly. You may feel dizzy when you stand up because gravity is pulling blood down toward your feet. This is a common condition called orthostatic hypotension.
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Diagnosing High Or Low Blood Pressure
Only one of your numbers needs to be higher than it should be to be diagnosed with high blood pressure, and only one needs to be lower than it should be to be diagnosed with low blood pressure.
So if your top number is over 140 or the bottom number is over 90, you may be diagnosed with high blood pressure, regardless of the other number. If your top number is under 90 or your bottom number is under 60, you may be diagnosed with low blood pressure. Use the chart to see where your numbers sit.
If your top number is consistently higher than 140mmHg, but the bottom number is healthy – this is known as Isolated Systolic Hypertension. If the bottom number is consistently higher than 90mmHg but the top number is healthy – this is known as Isolated Diastolic Hypertension.
Making sure your readings arent a one-off
A single high reading doesnt necessarily mean you have high blood pressure, as many things can affect your blood pressure throughout the day, such as the temperature, when you last ate, and if youre feeling stressed.
Your doctor or nurse will probably want to measure your blood pressure a number of times over a few weeks to make sure the reading wasnt just a one off and that your blood pressure stays high over time.
Read about how high blood pressure is diagnosed, getting a blood pressure check, the further tests you might have if you have a high blood pressure reading, and what it means if youre diagnosed with high blood pressure.
Read more
What Is A Good Blood Pressure
Its important to emphasize that a good blood pressure reading depends on your own individual health. Your provider will be able to tell you whats healthy and safe given your personal health circumstances.
Nonetheless, below are guidelines from the American Heart Association for people in general. Remember: Your blood can be temporarily high or low at times . This chart applies to how your blood pressure is normally, which is why you may want to take an average of several readings before seeing where you fall.
| Blood pressure category |
|---|
*Adapted from the American Heart Association
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Taking Your Pulse Versus Checking Your Blood Pressure
While both are indications of health, blood pressure and heart rate are two separate measurements. Learn more about the difference between blood pressure and heart rate.
Systolic is less than 120 and my diastolic is less than 80
Great job! Your blood pressure is normal. To keep your readings in this range, stick with heart-healthy habits like following a balanced diet and getting regular exercise.
Systolic is 120 129 and my diastolic is less than 80
The good news is that you dont have high blood pressure. However, your numbers fall within the Elevated category, making you more likely to develop high blood pressure unless you take action to control it. Ready to make some small changes that have big impacts? Healthy lifestyle choices are a great place to start.
Systolic is 130 139 or my diastolic is 80 89
You are in the first stage of hypertension, but there are actions you can take to get your blood pressure under control. Your doctor will speak to you about small changes that can make a big difference and other BP Raisers. In addition, monitoring blood pressure outside of the doctors office is important for BP control.
Systolic is 140 or higher or my diastolic is 90 or higher
Systolic is higher than 180 and/or my diastolic is higher than 120
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
What Should I Do If I Have High Blood Pressure
If you have been diagnosed with high blood pressure, you and your healthcare provider will talk about your target blood pressure. Your provider may suggest that you:
- Check your own blood pressure regularly with a home blood pressure monitor. These electronic monitors are available at most pharmacies or online.
- Work on controlling anger and managing stress.
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How Can You Manage Your High Blood Pressure
Treatment of high blood pressure often starts with lifestyle changes, including decreasing salt in your diet, losing weight if necessary, stopping smoking, cutting down on alcohol use, and regular exercise.
In addition to lifestyle changes, medications are often used to lower blood pressure. There are several types of medications that treat high blood pressure with each type of medication having benefits and risks that should be carefully weighed by you and your health care provider. Most people take more than one medication in order to bring their blood pressure down to their treatment goal.
Your blood pressure medication should begin to work within days. However, because high blood pressure is a long-lasting medical condition that often has little or no symptoms, remembering to take your medications can be a challenge. Combination medicines, long-acting or once-a-day medications, may be used to decrease the burden of taking numerous medications and help ensure medications regularly. Once started, the medication should be used until your doctor tells you to stop.
Controlling your blood pressure should be part of a healthy living plan and lifelong task. The damage that high blood pressure causes your internal organs does not cause any symptoms until serious damage has been done.
Measuring Your Blood Pressure At Home
You can also diagnose yourself with hypertension by measuring your blood pressure at home. If readings are high over two visits at the doctors office, and if your blood pressure is higher than 135/85 mmHg when properly measured at home, then the diagnosis of hypertension can be made. This requires you to measure your blood pressure twice a day, in the morning and evening, for one week. Pay no attention to the measurements from the first day. Measuring blood pressure at home requires accurate equipment and proper measuring techniques. Measure the blood pressure of others in your house their blood pressure may also be high.
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How Serious Is Your Hypertension
Doctors classify hypertension according to systolic pressure and diastolic pressure readings and the effects various levels can have on your health.
Hypertension, or high blood pressure, is a health condition that affects about one in three American adults. But not everyone who has hypertension has high blood pressure to the same degree. Doctors use four hypertension categories to help classify how likely your blood pressure level is to affect your health: prehypertension, stage 1, stage 2, and hypertensive crisis.
Normal Blood Pressure
Blood pressure is measured by taking two different measurements of the pressure within your arteries: systolic pressure and diastolic pressure. Systolic pressure, the first or top number of the blood pressure reading, is the highest level of pressure in your arteries, which occurs when your heart muscle contracts and forces a burst of blood into the aorta. Diastolic pressure, which is the bottom number, is the pressure that exists within your arteries between heart muscle contractions, which is when your heart is filling with blood.
If your blood pressure reading is less than 120/80 millimeters of mercury or mm Hg , you have normal blood pressure. This means that your systolic pressure is less than 120 mm/Hg and your diastolic reading is less than 80 mm/Hg.
Prehypertension: When Blood Pressure Is Above Normal
Stage 1 and Stage 2 Hypertension
Hypertensive Crisis: A High Blood Pressure Emergency
How Do I Know If I Have High Blood Pressure
High blood pressure usually doesnt cause symptoms. The only way to know if you have high blood pressure is to have your blood pressure taken. Know your numbers so you can make the changes that help prevent or limit damage.
Your blood pressure reading has two numbers. The top number is the systolic, which measures the pressure on the blood vessel walls when your heart beats. The bottom number is the diastolic, which measures the pressure on your blood vessels between beats when the heart is at rest.
For example, a reading of 110/70 is within normal range for blood pressure 126/72 is an elevated blood pressure a reading of 135/85 is stage 1 hypertension, and so on .
| Category | |
|---|---|
| Hypertensive Crisis | 180/120 mmHg or higher |
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