High blood pressure rarely causes symptoms, so measuring it is the only way to know. What the numbers mean, how to measure at home, and the lifestyle changes and medicines that lower it.
Why high blood pressure is called a "silent" condition
Nearly half of adults in the US have high blood pressure, and many don't know it. It usually causes no symptoms at all, even when readings are high – the only way to find out is to measure it.
Over the years, high blood pressure damages the arteries. That raises the risk of heart attack, stroke, heart failure, kidney disease and vision loss. The good news is that lowering it cuts those risks.
What your numbers mean
A reading has two numbers, measured in mm Hg:
- Systolic (the top number): the pressure when your heart beats
- Diastolic (the bottom number): the pressure when your heart rests between beats
| Category | Top number | Bottom number | |
|---|---|---|---|
| Normal | Below 120 | and | Below 80 |
| Elevated | 120–129 | and | Below 80 |
| Stage 1 high blood pressure | 130–139 | or | 80–89 |
| Stage 2 high blood pressure | 140 or higher | or | 90 or higher |
| Severe high blood pressure | Higher than 180 | and/or | Higher than 120 |
Ranges from the American Heart Association. A diagnosis is based on the average of several readings taken on different days, not a single high number.
Symptoms of very high blood pressure
Headaches and nosebleeds are not reliable signs of high blood pressure. But if your reading is higher than 180/120:
- With symptoms – chest pain, shortness of breath, back pain, numbness or weakness, a change in vision, difficulty speaking or a severe headache – call 911.
- Without symptoms – wait a few minutes and measure again. If it's still that high, contact your doctor straight away.
How to measure your blood pressure at home
- Use a validated upper-arm monitor with the right cuff size for your arm. Wrist monitors are less accurate.
- Don't have caffeine, exercise or smoke for 30 minutes before, and empty your bladder.
- Sit quietly for 5 minutes with your back supported, feet flat on the floor and your arm resting at heart level.
- Put the cuff on bare skin, and don't talk while it measures.
- Take 2 readings a minute apart, in the morning and evening, and write them down for your doctor.
How high blood pressure is treated
Lifestyle changes lower blood pressure for most people, and are the first step for elevated and stage 1 readings:
- Eat less salt – aim for under 2,300 mg of sodium a day, and ideally closer to 1,500 mg
- Follow a DASH-style diet: vegetables, fruit, whole grains, low-fat dairy, beans and nuts
- Get about 150 minutes of moderate exercise a week, such as brisk walking
- Limit alcohol, reach a healthy weight, stop smoking and get enough sleep
Medicines are added when lifestyle changes aren't enough, or straight away if your blood pressure is high or you have other risks. Common types include:
- ACE inhibitors, such as lisinopril
- Angiotensin receptor blockers (ARBs), such as losartan
- Calcium channel blockers, such as amlodipine
- Thiazide-type diuretics, such as hydrochlorothiazide or chlorthalidone
Many people need two medicines to reach their target. Keep taking them even when you feel fine, and don't stop without talking to your doctor. Our guide to blood pressure medicines compares the most common ones. PharmacyFarm dispenses them after our pharmacist has verified your prescription.
Frequently asked questions
What is a normal blood pressure?
Below 120/80 mm Hg for adults.
Can you feel high blood pressure?
Usually not. Most people feel completely well, which is why regular checks matter – at least once a year, and more often if your readings have been high.