Health & Body Tables
Blood Pressure Chart
A blood pressure reading is two numbers, and the reason there are two is that the heart does two different things. Systolic pressure is the peak while the left ventricle contracts; diastolic is the trough while it refills. Both matter, and a reading is only normal if both are.
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That is why the categories are joined by or rather than and. A reading of 118 over 92 looks reassuring on the top number but is Stage 2 hypertension by the diastolic value alone. Isolated diastolic hypertension is less common than isolated systolic, but it carries real risk, particularly in younger adults.
The thresholds themselves are not universal, and this is the single most confusing thing about blood pressure charts. The American College of Cardiology lowered the definition of hypertension to 130/80 in 2017. Europe and the UK still use 140/90, and the UK additionally uses a home threshold of 135/85 because readings taken at home average about 5 mmHg lower than readings taken in a clinic. A person at 135/85 is hypertensive in Manchester and normal-but-elevated in Boston, under guidelines that are both current and both evidence-based.
Two derived numbers are worth knowing. Pulse pressure is systolic minus diastolic, and a value much above 60 suggests stiff arteries, which is a risk marker independent of the absolute pressure. Mean arterial pressure is diastolic plus one third of the pulse pressure, and it is the number that determines whether organs are being perfused — which is why a systolic of 85 with a diastolic of 60 is more alarming than the top number alone suggests.
AHA/ACC 2017 categories (the US thresholds)
| Category | Systolic (mmHg) | Diastolic (mmHg) | What it means |
|---|---|---|---|
| Normal | below 120 | and below 80 | No action beyond usual habits |
| Elevated | 120 to 129 | and below 80 | Lifestyle changes, recheck in 3 to 6 months |
| Stage 1 | 130 to 139 | or 80 to 89 | Lifestyle plus medication if risk is high |
| Stage 2 | 140 or above | or 90 or above | Medication plus lifestyle |
| Crisis | above 180 | and/or above 120 | Seek medical care immediately |
The two columns are joined by OR, not AND. A reading of 118/92 is Stage 2 because the diastolic number qualifies, even though the systolic one looks fine.
Reading grid: systolic down, diastolic across
| Systolic \ Diastolic | 60 | 70 | 80 | 90 | 100 | 110 |
|---|---|---|---|---|---|---|
| 110 | Normal | Normal | Stage 1 | Stage 2 | Stage 2 | Stage 2 |
| 120 | Elevated | Elevated | Stage 1 | Stage 2 | Stage 2 | Stage 2 |
| 130 | Stage 1 | Stage 1 | Stage 1 | Stage 2 | Stage 2 | Stage 2 |
| 140 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 |
| 150 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 |
| 160 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 |
| 170 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 |
| 180 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 | Stage 2 |
This grid uses the AHA 2017 thresholds. Under the European 140/90 definition every cell marked Stage 1 would read as high-normal instead.
Worked readings with pulse pressure and mean arterial pressure
| Systolic | Diastolic | Pulse pressure | Mean arterial | AHA category |
|---|---|---|---|---|
| 110 | 70 | 40 | 83.3 | Normal |
| 120 | 80 | 40 | 93.3 | Stage 1 |
| 125 | 75 | 50 | 91.7 | Elevated |
| 130 | 85 | 45 | 100 | Stage 1 |
| 135 | 85 | 50 | 101.7 | Stage 1 |
| 140 | 90 | 50 | 106.7 | Stage 2 |
| 150 | 95 | 55 | 113.3 | Stage 2 |
| 160 | 100 | 60 | 120 | Stage 2 |
| 180 | 110 | 70 | 133.3 | Stage 2 |
Pulse pressure is systolic minus diastolic; 40 is typical. Mean arterial pressure is diastolic plus one third of the pulse pressure, and it is the number that matters for organ perfusion.
Where the main guidelines set the line
| Guideline | Hypertension starts at | Home target for most adults |
|---|---|---|
| AHA/ACC 2017 (US) | 130/80 | below 130/80 |
| ESC/ESH 2024 (Europe) | 140/90 | 120 to 129 systolic if tolerated |
| NICE NG136 (UK) | 140/90 clinic, 135/85 home | below 140/90 clinic |
| WHO/ISH | 140/90 | below 140/90 |
Home readings run about 5 mmHg lower than clinic readings, which is why NICE uses a separate home threshold. A 135/85 at home is equivalent to 140/90 in a clinic.
How to Use These Tables
- Classify a reading: find the systolic row and the diastolic column. A 145/85 lands in Stage 2 because the systolic value alone qualifies.
- Check both numbers: never clear a reading on the strength of one. 118/95 is Stage 2, not normal.
- Compute pulse pressure: subtract diastolic from systolic. A reading of 160/70 has a pulse pressure of 90, which is wide and worth mentioning to a clinician.
- Convert a home reading to a clinic equivalent: add about 5 mmHg. A home average of 135/85 corresponds roughly to 140/90 in a clinic.
- Track a trend rather than a single reading: blood pressure varies by 10 mmHg through the day. Take two readings a minute apart, morning and evening, and average over a week.
Common Questions
Which number matters more, systolic or diastolic?
Both, and the higher category wins. Systolic is the stronger predictor of risk after age 50, while diastolic matters more in younger adults. A chart that only checks the top number will miss isolated diastolic hypertension.
Why do US and European guidelines disagree?
They interpreted the same trial evidence differently. The 2017 US guideline reclassified 130 to 139 over 80 to 89 as Stage 1 to prompt earlier lifestyle intervention; Europe kept 140/90 as the diagnostic line and treats the 130s as high-normal.
Is 135/85 high?
It depends where it was measured. In a clinic, 135/85 is high-normal under European guidelines and Stage 1 under US guidelines. At home, 135/85 is above the NICE home threshold and counts as hypertension in the UK.
What is a dangerous blood pressure?
Above 180 systolic or 120 diastolic is a hypertensive crisis and needs medical attention the same day, especially with chest pain, breathlessness, vision change or weakness. Values in the 140s to 170s are high but not emergencies on their own.
What is pulse pressure and why does it matter?
It is systolic minus diastolic, normally about 40 mmHg. A persistently wide pulse pressure above 60 suggests arterial stiffness and is an independent cardiovascular risk marker, common in older adults with isolated systolic hypertension.
How much does blood pressure vary during the day?
A healthy person swings 10 to 20 mmHg over 24 hours, lowest during sleep and highest in the early morning. Single readings are unreliable, which is why guidelines ask for averages over several days.
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Sources
- 2017 ACC/AHA Guideline for the Prevention, Detection and Management of High Blood Pressure — American College of Cardiology / American Heart Association
- 2024 ESC Guidelines for the management of elevated blood pressure and hypertension — European Society of Cardiology
- NICE NG136 — Hypertension in adults: diagnosis and management — National Institute for Health and Care Excellence
Filed with Health calculations.