Blood Pressure: How High Is Too High?
Key takeaways:
Normal blood pressure is 120/80 or lower. Untreated high blood pressure increases the risk of other serious health problems, like heart disease, stroke, and kidney disease.
Blood pressure higher than 180/120 can be a medical emergency. Seek medical care if you see a blood pressure reading in this range.
High blood pressure usually doesn’t cause symptoms, so it’s important to check for it.
Table of contents
High blood pressure is very common. In the U.S., nearly half of adults over age 18 have high blood pressure or take medication to treat it.
If your blood pressure remains high, it increases the risk of other serious health problems, like heart disease, stroke, and kidney disease. High blood pressure doesn’t usually cause any symptoms. That’s why it’s important to get your blood pressure checked.
The good news is that high blood pressure can be treated with lifestyle changes and medication. Let’s take a closer look at what your blood pressure numbers mean and what to do if your blood pressure is too high.
How to read blood pressure
Your blood pressure reading consists of two numbers, such as 120/80. The top number is your systolic blood pressure and the bottom number is your diastolic pressure. Here’s what those terms mean:
Systolic blood pressure: This is the pressure when the heart pumps blood out to the rest of the body.
Diastolic blood pressure: This is the pressure when blood returns to the heart.
Both pressures are measured in millimeters of mercury (mmHg). This is because blood pressure used to be measured using a device filled with a column of mercury. Now, blood pressure can be checked using an automated machine at home or in a healthcare professional’s office. Blood pressure can still be checked by hand, too, with a stethoscope, inflatable cuff, and manual gauge.
What high blood pressure feels like: High blood pressure often has no symptoms. Here’s how to detect it.
Looking for ways to lower your blood pressure? Here are a few tips to bring down your blood pressure safely.
When is high blood pressure an emergency? Learn more about when to go to the emergency room for high blood pressure.
Which number is more important, systolic or diastolic?
It’s important to monitor both numbers when your blood pressure is checked. It’s possible for either of the numbers to be elevated. Both systolic and diastolic blood pressures have been shown to increase the risk of heart disease if they’re high.
What blood pressure is too high?
There are different categories for normal, elevated, and high blood pressure, according to 2017 guidelines from the American College of Cardiology and the American Heart Association.
Normal: systolic below 120, diastolic below 80
Elevated: systolic 120 to 129, diastolic below 80
High (hypertension): systolic above 130, diastolic above 80
You have high blood pressure (hypertension) if one or both numbers in your blood pressure reading are high.
The category of hypertension is further divided into stages:
Stage 1: systolic 130 to 139, or diastolic 80 to 89
Stage 2: systolic at or above 140, or diastolic at or above 90
These stages are used to make decisions about how to treat high blood pressure. For example, if your blood pressure is in stage 1, you may not need to treat it with medications right away.
Hypertensive crisis
A blood pressure with a systolic reading at or above 180 or a diastolic reading at or above 120 is very elevated. This is called hypertensive crisis. Even when your blood pressure is this high, you may not have any symptoms. Without symptoms, this is also referred to as hypertensive urgency.
In some cases, blood pressure this high can damage other organs in the body, which causes symptoms. This is called hypertensive emergency, and some of the complications can be life-threatening. Affected organs can include the:
Eyes
Kidneys
Heart
Brain
Depending on which organ is involved, you can have different symptoms with a hypertensive emergency. For example, if the heart is affected, you may have chest pain. Other symptoms to look for include:
Vision changes
Confusion
Shortness of breath
Nausea or vomiting
Severe back pain
Weakness or numbness/tingling
Change in speech
Blood work and other testing is usually done to diagnose and treat hypertensive emergencies. Treatment involves lowering the blood pressure with medication. How quickly the blood pressure is lowered and which medication is used depends on which organs are affected.
If you ever have a blood pressure at or above 180/120 mmHg, don’t ignore it, even if you feel fine. You should contact a healthcare professional immediately or go to the nearest emergency room.
Take our quiz
Are you at high risk for high blood pressure?
What causes high blood pressure?
High blood pressure, also called hypertension, happens when the heart pumps blood against the artery walls at higher pressures than normal. But it isn’t diagnosed from just one reading. You need at least two or more readings on 2 or more separate days before you can know whether you have high blood pressure. This is because your blood pressure changes from day to day and throughout each day, depending on what you’re doing. It can increase temporarily due to:
Caffeine
Smoking
Exercise
Chronic high blood pressure is usually the result of many different factors. These can include:
Age (risk of high blood pressure increases as you age)
Genetics or a family history of high blood pressure
Diet (too much sodium or salt)
Obesity
Inactive lifestyle
Alcohol use
Smoking
Medications
Kidney conditions
How can I check my blood pressure at home?
Monitoring your blood pressure at home is a great way to stay on top of your blood pressure readings. This way, you can get treatment or make adjustments in your treatment early. And this can prevent complications from high blood pressure over time.
You can buy an automated home blood pressure cuff online, without a prescription, or at local stores and pharmacies. Some insurance companies may also pay for a home cuff as long as you have a prescription or order from a healthcare professional.
Some people always have high blood pressure in a healthcare setting, but normal blood pressure at home. This is called “white coat hypertension.” Monitoring your blood pressure at home can help sort this out.
Home blood pressure monitoring is also recommended as part of your diagnosis and treatment of high blood pressure, according to current guidelines. It’s a great way to get more information about how your blood pressure changes over time. Sharing your home readings with a healthcare professional can help you come up with a treatment plan.
How to take an accurate blood pressure reading
When you take your blood pressure, there are a few key points to keep in mind to get an accurate reading:
Take your blood pressure in a seated position, with your back supported and your feet flat on the floor.
Sit quietly for at least 5 minutes before you take it.
Place the cuff on your upper arm above the bend in your elbow.
Rest your arm on a table so your upper arm is at the level of your heart.
Avoid taking your blood pressure within 30 minutes of exercise, consuming caffeine, or smoking.
How often should I check my blood pressure?
High blood pressure doesn’t always cause symptoms, so it’s important to get your blood pressure checked. Recent guidelines recommend that all adults age 40 and older check their blood pressure at least once per year. Younger adults can check it every 3 to 5 years, or every year if they’re at higher risk.
If you already have high blood pressure, you’ll need to check your blood pressure more frequently — especially when you’re starting or adjusting medications. Once your blood pressure stabilizes with treatment, you usually won’t need to check it as often. Regular monitoring is still important though. That’s because your blood pressure can change over time, even when you’re taking medications.
How can I treat high blood pressure?
High blood pressure is very treatable. Treatment includes medications and changes you can make in your everyday life. Changes you can make to lower your blood pressure include:
Eating less salt
Getting regular exercise
Limiting alcohol
Not smoking
In some cases, making these changes may be enough to lower your blood pressure. If your blood pressure remains high, you may need to start taking medication to bring it down.
Frequently asked questions
Taking some deep breaths and trying to relax can sometimes help to bring blood pressure down quickly if it’s not very elevated. If your blood pressure is very high — at least 180/120 — you shouldn’t rely on at-home methods to lower your blood pressure. You should contact a healthcare professional right away.
Yes, anxiety can cause a short-term rise in blood pressure. You can develop chronic high blood pressure if you have chronic stress and cope with lifestyle behaviors like:
Smoking
Alcohol use
Unbalanced diet
Lack of sleep
People with hypertensive emergency are at higher risk of complications like stroke. When blood pressures are greater than 180/120, blood vessels in the brain are at risk of being damaged. This can make it more likely to develop a stroke. Never ignore blood pressure in this dangerously high range. It’s always best to get medical care right away.
The bottom line
High blood pressure, or hypertension, is defined as blood pressure higher than 130/80 mmHg. It can be tricky because it usually doesn’t cause any symptoms, even when it’s very high. But it can have serious complications, so it’s important to get your blood pressure checked throughout your life. The good news is that it can be easily treated in most cases. Monitoring your blood pressure at home is an easy and important part of detecting and managing high blood pressure.
Why trust our experts?
References
American Heart Association. (2024). Home blood pressure monitoring.
American Heart Association. (2024). How to manage high blood pressure.
American Heart Association. (2024). When to call 911 about high blood pressure.
Centers for Disease Control and Prevention. (2024). High blood pressure risk factors.
National Center for Health Statistics. (2023). Hypertension. Centers for Disease Control and Prevention.
National Heart, Lung, and Blood Institute. (2024). What is high blood pressure? National Institutes of Health.
U.S. Preventive Services Task Force. (2021). Hypertension in adults: Screening.
Whelton, P. K., et al. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Journal of the American College of Cardiology.
