TUESDAY, Feb. 5, 2019 — “140/90” had long been the line in the sand for getting high blood pressure under control. But in 2017, leading medical organizations lowered the definitions of normal, elevated and high blood pressure with the idea that starting treatment at lower “high” levels can better reduce heart attacks and strokes.

This dramatically added to the number of people diagnosed with high blood pressure and redefined goals for those with the condition.

Blood Pressure by the Numbers:

• Normal: Less than 120/80 mm Hg on both numbers. (The top number is the systolic pressure, which measures pressure when your heart beats; the bottom number is the diastolic pressure, which is when your heart is at rest, between beats.)
• Elevated: A systolic reading of 120-129 and a diastolic reading of less than 80 mm Hg.
• High blood pressure stage 1: A systolic reading of 130-139 or a diastolic reading of 80-89 mm Hg.
• High blood pressure stage 2: A systolic reading of 140 or higher, or a diastolic reading of 90 or higher mm Hg.
• Crisis level needing immediate attention: A systolic reading above 180 and/or a diastolic reading above 120 mm Hg.

As part of the new guidelines, the target measurement for high blood pressure patients with existing heart disease was trimmed to less than 130/80 mm Hg. That guideline also applies to people with a 10 percent or higher risk of developing heart disease over 10 years. For these people, medication is now typically given to achieve the goal.

For adults with stage 1 hypertension whose estimated 10-year heart disease risk is less than 10 percent, bringing the numbers down to 130/80 is desired.

Lifestyle changes are their first line of treatment, with re-evaluation within six months. Habits that can lower blood pressure include losing weight, exercise, limiting alcohol and salt, and following a diet such as DASH, which emphasizes portion size and prioritizes vegetables, fruits and low-fat dairy products.

Since just walking into the doctor’s office can temporarily elevate blood pressure for some, home monitoring is recommended. Also, some doctors don’t follow exact guidelines for taking patients’ blood pressure in the office setting, which includes two readings two minutes apart.

More information

To learn about your risk for future heart events based on blood pressure and other health indicators, check out the American College of Cardiology risk estimator online.

Posted: February 2019

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