Normal Blood Pressure Ranges in Adults
Normal blood pressure in adults, regardless of age, is defined as less than 120 mmHg systolic AND less than 80 mmHg diastolic. 1, 2
Blood Pressure Classification
The current standard classification system applies uniformly to all adults aged 18 years and older, without age-specific variations: 3, 1
- Normal: <120/<80 mmHg 1, 2, 4
- Elevated: 120-129/<80 mmHg 1, 2, 4
- Stage 1 Hypertension: 130-139/80-89 mmHg 1, 2, 4
- Stage 2 Hypertension: ≥140/≥90 mmHg 1, 2, 4
When systolic and diastolic readings fall into different categories, the higher category determines the classification. 3
Key Clinical Context
The definition of "normal" blood pressure has evolved based on cardiovascular outcomes data. The American College of Cardiology and American Heart Association established the <120/<80 mmHg threshold because cardiovascular risk increases progressively throughout the entire blood pressure spectrum, with no clear threshold below which risk disappears. 3
Blood pressure readings between 120-129/<80 mmHg, while previously considered "normal," are now classified as "elevated" because individuals in this range have double the risk of developing hypertension compared to those with truly normal values. 3
The category formerly called "prehypertension" (120-139/80-89 mmHg) has been subdivided into "elevated" and "stage 1 hypertension" to better stratify cardiovascular risk and guide earlier intervention. 3, 1
Age-Independent Standard
These blood pressure definitions apply uniformly across all adult age groups, from 18 years through 80+ years. 1, 2 While blood pressure naturally tends to rise with age—with only 5% of adults aged 75+ maintaining normal blood pressure—the definition of what constitutes "normal" does not change. 5
The American College of Cardiology explicitly states that normal blood pressure for older adults (≥65 years) remains <130/80 mmHg, using the same classification system as younger adults. 2
Measurement Requirements
Blood pressure classification should be based on an average of at least 2 properly measured readings obtained on at least 2 separate occasions. 1 Proper technique includes: 1
- Patient seated quietly for at least 5 minutes
- Back supported, feet flat on floor
- Arm supported at heart level
- Readings taken 1 minute apart
- Use of validated, calibrated devices with appropriate cuff size
Out-of-office measurements (home or ambulatory monitoring) are essential to confirm diagnosis, as they provide more accurate cardiovascular risk assessment than isolated office readings. 1