What is the meaning of a blood pressure reading of 120/107 millimeters of mercury (mmHg), indicating stage 2 hypertension?

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From the Guidelines

A blood pressure reading of 120/107 mmHg indicates Stage 2 hypertension, which requires prompt medical attention. The top number (120) represents systolic pressure, which is normal, but the bottom number (107) represents diastolic pressure, which is significantly elevated above the normal range of less than 80 mmHg, as defined by the 2017 American College of Cardiology/American Heart Association hypertension guideline 1. You should contact your healthcare provider immediately as this level of diastolic hypertension increases your risk for heart attack, stroke, kidney damage, and other complications.

Key Points to Consider

  • The 2017 guideline replaces the term “prehypertension” with “elevated BP” (average SBP of 120 to 129 mm Hg and average DBP <80 mm Hg) and “stage 1 hypertension” (average SBP of 130 to 139 mm Hg or average DBP of 80 to 89 mm Hg) 1.
  • Stage 2 hypertension is defined as an average SBP of at least 140 mm Hg or an average DBP of at least 90 mm Hg instead of a BP of at least 160/100 mm Hg, according to the same guideline 1.
  • Treatment typically involves prescription medications such as ACE inhibitors (like lisinopril), calcium channel blockers (like amlodipine), or diuretics (like hydrochlorothiazide), often starting at low doses and adjusting as needed 1.
  • While waiting for medical care, reduce sodium intake, avoid alcohol and caffeine, manage stress, and rest quietly.
  • This elevated diastolic pressure indicates that your arteries remain under high pressure even between heartbeats, putting continuous strain on your blood vessels and heart.
  • Regular monitoring and adherence to prescribed treatment will be essential for bringing your blood pressure to a healthier range.

From the Research

Understanding Blood Pressure Readings

  • A blood pressure reading of 120/107 mmHg is considered abnormal, with the top number (systolic pressure) being within a relatively normal range, but the bottom number (diastolic pressure) being significantly elevated.
  • According to various studies 2, 3, 4, a normal blood pressure target is typically less than 140/90 mmHg, and in certain cases such as diabetes or renal insufficiency, the target may be even lower, at less than 130/85 mmHg or less than 125/75 mmHg.

Diastolic Hypertension

  • The provided blood pressure reading of 120/107 mmHg indicates diastolic hypertension, which is a condition where the diastolic blood pressure is elevated 5.
  • Diastolic hypertension can be a significant risk factor for cardiovascular disease, and it is essential to manage and control blood pressure to reduce this risk.

Managing Hypertension

  • Studies suggest that combination therapy, including medications such as ACE inhibitors, ARBs, calcium channel blockers, and diuretics, may be necessary to achieve adequate blood pressure control 2, 3, 6.
  • The choice of antihypertensive medication depends on various factors, including the patient's underlying medical conditions, such as diabetes, heart failure, or chronic kidney disease 2, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Managing Hypertension Using Combination Therapy.

American family physician, 2020

Research

Treating stage 2 hypertension.

Journal of clinical hypertension (Greenwich, Conn.), 2005

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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