High blood pressure guidelines

Guidelines from the U.S. National Institutes of Health define high blood pressure and its treatment.1

Blood pressure guidelines
Blood pressure Classification
140/90 or above High
120/80 to 139/89 Prehypertension
119/79 or below Normal

Key points from the guidelines:

  • If you have a blood pressure of 120 to 139 systolic (the upper number in a blood pressure measurement) over 80 to 89 diastolic (lower number), you have prehypertension. Prehypertension is blood pressure that is higher than normal but not high enough to be high blood pressure. It is a warning that your blood pressure is going up. You need to begin lifestyle changes to lower your risk for stroke, heart disease, and other problems caused by high blood pressure. Lifestyle changes include the following:
    • Lose extra weight.
    • Get more active.
    • Limit alcohol.
    • Eat a heart-healthy diet.
    • Eat less salt.
    • Quit smoking.
  • The increase in stroke and heart disease risk begins at blood pressures as low as 115/75 and doubles with each increase of 20 systolic and 10 diastolic. For example, if your blood pressure were to increase from 115/75 to 135/85, your risk of stroke and heart attack would double.
  • The lifetime risk for high blood pressure is much greater than previously thought. Out of every 100 people who don't already have high blood pressure by the time they reach age 55, 90 of them will get it eventually. That means only 10 of those 100 will not get high blood pressure.
  • If you are older than 50, a systolic blood pressure (the upper number) over 140 is a more important risk factor for stroke and heart disease than your diastolic blood pressure (the lower number).
  • Most people with high blood pressure will need two or more medicines, including a thiazide-type diuretic, to lower their blood pressure to below 140/90, the goal for people with high blood pressure that hasn't caused other health problems.
  • If you have other conditions, such as diabetes, heart failure, coronary artery disease, or chronic kidney disease, your goal blood pressure is less than 130/80.


  1. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003). Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC Express (NIH Publication No. 03–5233). Bethesda, MD: U.S. Department of Health and Human Services.

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