From the Guidelines
A normal blood pressure reading is generally considered to be less than 120 mm Hg for systolic blood pressure and less than 80 mm Hg for diastolic blood pressure. The top number (systolic pressure) represents the force when your heart beats and pushes blood through your arteries, while the bottom number (diastolic pressure) represents the pressure in your arteries when your heart rests between beats. Blood pressure below 120/80 mmHg is optimal, while readings between 120/80 and 129/80 mmHg are considered elevated 1. Hypertension (high blood pressure) is diagnosed when readings consistently show 130/80 mmHg or higher.
Key Points to Consider
- Blood pressure naturally fluctuates throughout the day based on activity levels, stress, and other factors, so multiple readings over time provide a more accurate assessment than a single measurement.
- Regular monitoring is important, especially for those with risk factors like family history of hypertension, advanced age, obesity, or certain medical conditions.
- Maintaining normal blood pressure is crucial for cardiovascular health as elevated levels can damage blood vessels and increase the risk of heart disease, stroke, and kidney problems.
- The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines recommends that individuals with systolic and diastolic blood pressures in two categories should be designated to the higher blood pressure category 1.
Importance of Recent Guidelines
The most recent guidelines from 2018 provide the most up-to-date information on blood pressure categories, emphasizing the importance of early detection and management of high blood pressure to prevent cardiovascular disease 1. These guidelines supersede previous recommendations and should be followed for the best patient outcomes.
Lifestyle Modifications
In addition to monitoring blood pressure, lifestyle modifications such as weight control, increased physical activity, alcohol moderation, sodium reduction, and emphasis on increased consumption of fresh fruits, vegetables, and low-fat dairy products are recommended to help manage and prevent high blood pressure 1.
From the Research
Definition of Normal Blood Pressure
- Normal blood pressure is typically defined as a systolic blood pressure of less than 120 mmHg and a diastolic blood pressure of less than 80 mmHg 2
- However, some studies suggest that a blood pressure of 115/75 mmHg is associated with minimal vascular mortality and may be considered optimal 3
- The American Society of Hypertension recommends that blood pressures above 140/90 mmHg are probably abnormal, and that blood pressures below 135/85 mmHg are probably normal 4
Ambulatory Blood Pressure Measurement
- The European Society of Hypertension defines normal 24-h ambulatory blood pressure as lower than 125/80 mmHg 5
- Another definition of normal ambulatory blood pressure is lower than 135/85 mmHg for awake blood pressure and lower than 120/70 mmHg for asleep blood pressure 5
- A study found that there is a good agreement between these two definitions, but some subjects may be classified as hypertensive only according to one of these methods 5
Blood Pressure Levels and Cardiovascular Risk
- A blood pressure of 115/75 mmHg is associated with minimal vascular risk 3
- A study found that individuals with prehypertensive levels of blood pressure (120/80 to 139/89 mmHg) have an increased risk of developing cardiovascular disease relative to those with optimal levels 2
- Another study found that a mean blood pressure of less than 140/80 mmHg is associated with a reduced risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients 6