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Biomarkers

Blood pressure (BP)

Q: What blood pressure is considered normal?

Optimally below 120/80 mmHg. By ACC/AHA criteria 120–129/<80 is already "elevated", and from 130/80 it is stage 1 hypertension. In Russia and Europe a diagnosis of hypertension is usually made from 140/90, and 130–139/85–89 is called "high normal".

Q: Which matters more — the upper or the lower number?

Both matter, but with age systolic (the upper) becomes the leading risk factor: it reflects the stiffness of the large arteries. In young people more attention is paid to diastolic. In any case, a rise in either number needs assessment.

Q: My pressure jumps around — what to do?

Occasional fluctuations are normal (stress, coffee, exertion). What matters is not a single number but the trend: keep a diary of home measurements in a calm setting. Persistently high values or large swings are a reason to see a doctor and possibly do ABPM.

The pressure of blood on the artery walls, given as two values: SBP/DBP

Blood pressure — a monitor and the heart, measuring blood pressure

Blood pressure (BP) is the force with which blood pushes against the walls of the arteries. It is written as two numbers: systolic (upper) "over" diastolic (lower).

BP is one of the main cardiovascular risk factors: years of elevated pressure quietly damage the vessels and accelerate atherosclerosis. So keeping it under control is basic prevention of heart attack and stroke.

Reference ranges

Categories per 2017 ACC/AHA (mmHg); in Russia and Europe hypertension is diagnosed from 140/90:

Normal	< 120 and < 80
Elevated	120–129 and < 80
Hypertension stage 1 (ACC/AHA)	130–139 or 80–89
Hypertension stage 2	≥ 140/90
Hypertensive crisis	> 180 and/or > 120 — see a doctor urgently

Important: The diagnosis is not made from a single measurement: repeat readings in a calm setting are needed, and better still — home monitoring or 24-hour (ambulatory) monitoring.

What an elevated level means

Elevated pressure (hypertension) is asymptomatic for a long time — hence the name "silent killer". Over time it damages the heart, vessels, kidneys, eyes and brain, raising the risk of heart attack, stroke and dementia.

Factors: age, excess salt, excess weight, physical inactivity, alcohol, stress, heredity, kidney disease and hormonal causes (secondary hypertension).

What a low level means

Low pressure (hypotension, usually < 90/60) is often not dangerous in itself, especially in young and fit people.

Attention is needed for symptomatic hypotension: dizziness, weakness, blacking out on standing (orthostatic hypotension), as well as a sharp drop in pressure with dehydration, blood loss, infections or on medications.

How the test is done

Measure at rest, seated, after 5 minutes of rest, without coffee or smoking for 30 minutes; the cuff at heart level. Take 2–3 readings and average them.

Pressure in the clinic is often higher than at home ("white-coat hypertension"), so home measurements and 24-hour monitoring (ABPM) are valuable for the diagnosis.

What affects the value

Salt, excess weight, alcohol — raise pressure.
Stress, coffee, smoking — temporarily raise it.
"White coat" — pressure in the clinic is higher than at home.
Age — systolic rises over the years (arterial stiffness).
Physical activity and weight loss — lower it.
Dehydration, blood loss, medications — can lower it.

Assess blood pressure and risk

Determine your blood-pressure category and the risk of hidden hypertension:

Blood Pressure Categories Your ACC/AHA category, pulse and mean arterial pressure, risk score, and age-based norms Open Hypertension Risk Your blood pressure category by ACC/AHA, age- and sex-based norms, guidance, and impact on biological age Open

Frequently asked questions

What blood pressure is considered normal?

Optimally below 120/80 mmHg. By ACC/AHA criteria 120–129/<80 is already "elevated", and from 130/80 it is stage 1 hypertension. In Russia and Europe a diagnosis of hypertension is usually made from 140/90, and 130–139/85–89 is called "high normal".

Which matters more — the upper or the lower number?

Both matter, but with age systolic (the upper) becomes the leading risk factor: it reflects the stiffness of the large arteries. In young people more attention is paid to diastolic. In any case, a rise in either number needs assessment.

My pressure jumps around — what to do?

Occasional fluctuations are normal (stress, coffee, exertion). What matters is not a single number but the trend: keep a diary of home measurements in a calm setting. Persistently high values or large swings are a reason to see a doctor and possibly do ABPM.

Sources

info

This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.

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