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Biomarker library / Metabolic

Blood pressure (BP)

Also called systolic and diastolic pressure, hypertension numbers

Blood pressure is the force of blood against artery walls, written as two numbers: systolic (pressure while the heart beats) over diastolic (pressure between beats), in millimeters of mercury. The rows below are drawn on the systolic number, with the diastolic criterion in each note, because a reading falls into a category when either number qualifies.

Written by the VitalDecades editorial team Reviewed by the editorial review process Updated

01  /  Reference ranges

What counts as normal

Scale in mm Hg. Cut points from the sources listed below.

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Population Adults
Category Normal
Range under 120 mm Hg (systolic) And diastolic under 80.
Source 2025 AHA/ACC High Blood Pressure Guideline (categories unchanged from 2017)

Effective

Population Adults
Category Elevated
Range 120 to 129 mm Hg (systolic) With diastolic still under 80.
Source 2025 AHA/ACC High Blood Pressure Guideline (categories unchanged from 2017)

Effective

Population Adults
Category Stage 1 hypertension
Range 130 to 139 mm Hg (systolic) Or diastolic 80 to 89. Confirm with out-of-office readings.
Source 2025 AHA/ACC High Blood Pressure Guideline (categories unchanged from 2017)

Effective

Population Adults
Category Stage 2 hypertension
Range 140 or higher mm Hg (systolic) Or diastolic 90 and above.
Source 2025 AHA/ACC High Blood Pressure Guideline (categories unchanged from 2017)

Effective

Normal vs optimal

Normal is under 120 systolic AND under 80 diastolic. There is no bonus category below that; the guideline treats under 120/80 as the goal state.

02  /  Why it matters

What the number tells you

High blood pressure is the most consequential number on this site: it drives heart attack, stroke, kidney disease and dementia risk, usually silently. The 2025 AHA/ACC guideline (published August 14, 2025) kept the 2017 categories and pushed earlier treatment. Because a single office reading misclassifies many people, a high reading should be confirmed with out-of-office measurement (a home cuff or ambulatory monitor) before a diagnosis.

03  /  In practice

Testing and what moves it

When it is tested

  • At least yearly from age 40, and at every clinical visit at any age (USPSTF screens all adults).
  • Measured right: seated, back supported, feet on the floor, arm at heart level, no caffeine or exercise in the prior 30 minutes, cuff on a bare arm.
  • Home monitoring uses the average of morning and evening readings over several days, not one reading.

What raises it

  • Age, weight, high sodium intake, low activity, alcohol, poor sleep and sleep apnea, some medications (NSAIDs, decongestants), stress.
  • Transiently: caffeine, a full bladder, talking during the reading, a too-small cuff.

What lowers it

  • Weight loss, the DASH eating pattern, sodium reduction, activity, limiting alcohol, treating sleep apnea; medication when lifestyle is not enough.

04  /  Related

Read next

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2026-08-19

Frequently asked questions

What is a normal blood pressure by age?

The categories do not change with age: normal is under 120/80 for adults, per the 2025 AHA/ACC guideline. Treatment decisions and targets are individualized in older adults, but the definition of normal is not age-adjusted.

Which number matters more, the top or the bottom?

Both count, and a reading is staged by whichever number is worse. Systolic pressure tends to drive risk after midlife, which is why the rows here are drawn on it, with the diastolic criterion in each note.

My reading at the doctor is always higher than at home. Which is real?

Both are information. Office readings run higher for many people (white-coat effect), which is why the guideline confirms a diagnosis with out-of-office measurement. A validated home cuff, used correctly and averaged, is the better basis for decisions.