Blood Pressure Stages Explained: Normal, Elevated, Stage 1 & 2 Hypertension
Reading Blood Pressure: Systolic and Diastolic
Blood pressure is expressed as systolic/diastolic (e.g., 125/80 mmHg). Systolic (top number) is pressure when the heart beats. Diastolic (bottom number) is pressure when the heart rests between beats. Both numbers matter independently — you can have normal systolic with elevated diastolic (isolated diastolic hypertension) or vice versa.
ACC/AHA Blood Pressure Stages (2017 Guidelines)
Normal: <120/<80. Elevated: 120–129/<80. Stage 1 Hypertension: 130–139 or 80–89. Stage 2 Hypertension: ≥140 or ≥90. Hypertensive Crisis: >180 and/or >120 (requires immediate medical attention). The 2017 ACC/AHA guidelines lowered Stage 1 threshold from 140/90 to 130/80, classifying more people as hypertensive earlier.
White Coat Hypertension and Masked Hypertension
White coat hypertension: readings elevated at the doctor’s office but normal at home (due to anxiety). Masked hypertension: readings normal at the office but elevated at home. Home monitoring over multiple days provides a more accurate picture than a single clinic reading. Use Blood Pressure Tracker to log multiple readings and see patterns.
When Each Stage Requires Action
Elevated (120–129): lifestyle modification only (diet, exercise, sodium reduction). Stage 1 (130–139/80–89): lifestyle modification; medication only if cardiovascular risk >10%. Stage 2 (≥140/90): combination of lifestyle and medication. Hypertensive Crisis: immediate emergency care.
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