Blood Pressure
Blood pressure has two numbers: the systolic (the higher one, the pressure as the heart pumps) and the diastolic (the lower one, the pressure as the heart relaxes). Where a reading sits decides nothing on its own — a diagnosis of hypertension rests on repeated readings on separate days, and usually on readings taken at home or over 24 hours.
This is an educational reading aid, not a diagnosis and not medical advice. Reference ranges differ between laboratories — always read the range printed on your own report. Nothing here can see you, your history or your medicines. Do not start, stop or change any treatment on the strength of this page: take your report to a qualified doctor.
Reference ranges reviewed by Dr. Mohan Gayenlast reviewed
Your values
Fill in only the ones on your report. Anything you leave blank is simply skipped.
The pressure in the arteries as the heart contracts.
The pressure in the arteries as the heart relaxes between beats.
Enter one or more values and your reading will appear here.
ACC/AHA 2017 (American)
A category is set by whichever number is higher. 128/92 is Stage 2, because the diastolic says so.
| Category | Systolic (mmHg) | Diastolic (mmHg) | |
|---|---|---|---|
| Normal | below 120 | and | below 80 |
| Elevated | 120 – 129 | and | below 80 |
| Stage 1 hypertension | 130 – 139 | or | 80 – 89 |
| Stage 2 hypertension | 140 or above | or | 90 or above |
| Hypertensive crisis | above 180 | and/or | above 120 |
ESC/ESH (European)
The European classification sets hypertension at 140/90 in the clinic, and grades it above that.
| Category | Systolic (mmHg) | Diastolic (mmHg) | |
|---|---|---|---|
| Optimal | below 120 | and | below 80 |
| Normal | 120 – 129 | and/or | 80 – 84 |
| High normal | 130 – 139 | and/or | 85 – 89 |
| Grade 1 hypertension | 140 – 159 | and/or | 90 – 99 |
| Grade 2 hypertension | 160 – 179 | and/or | 100 – 109 |
| Grade 3 hypertension | 180 or above | and/or | 110 or above |
| Isolated systolic hypertension | 140 or above | and | below 90 |
Thresholds outside the clinic
Readings taken at home or over 24 hours are lower than clinic readings, and the thresholds move with them.
| Where measured | Hypertension at or above |
|---|---|
| Clinic / office | 140 / 90 mmHg (ESC) or 130 / 80 mmHg (ACC/AHA) |
| Home, averaged over several days | 135 / 85 mmHg |
| 24-hour ambulatory, daytime average | 135 / 85 mmHg |
| 24-hour ambulatory, night-time average | 120 / 70 mmHg |
| 24-hour ambulatory, 24-hour average | 130 / 80 mmHg |
What this panel is easy to get wrong
- ONE HIGH READING IS NOT HYPERTENSION. Blood pressure varies through the day, with stress, pain, caffeine, a full bladder and the walk to the clinic. Diagnosis needs readings on at least two separate occasions, and usually home or 24-hour monitoring.
- Measure it properly or do not measure it: sitting, back supported, feet flat, arm at heart level, no talking, and five minutes of rest first. A cuff that is too small reads falsely high.
- WHEN TO GET HELP IMMEDIATELY: a reading at or above 180/120 WITH chest pain, breathlessness, weakness or numbness on one side, difficulty speaking, severe headache, or visual change is a medical emergency — call emergency services. The same reading with no symptoms still needs same-day medical advice.
- These categories are for adults. Children have age-, sex- and height-based percentiles, and pregnancy has its own thresholds and its own dangers.
Where these ranges come from: ACC/AHA 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults; ESC/ESH classification shown alongside.
Where this is written from: This site is written from Indian clinical practice. Drug availability and brand names, vaccination schedules, national health programmes and some reference cut-offs differ between countries — a schedule or a threshold that is standard here may not be standard where you are. If you are reading outside India, check anything on this page against your own country’s guidance before you act on it.
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What your reading means, under both the American and European guidelines.