High blood pressure is sometimes called a “silent killer.” It often has no symptoms, which means many people don’t even know they have it. That’s why a healthcare provider often checks your blood pressure at medical appointments. Having high blood pressure can be dangerous as it increases your risk for heart attack, stroke, and other serious conditions.

If you have high blood pressure (called hypertension), you may be familiar with the numbers 140/90. The top number—140—is called systolic and the bottom—90—is called diastolic. According to past medical guidelines, these numbers (or higher) meant you had high blood pressure. But, with the new guidelines these numbers have changed.

Scroll down to learn about the new guidelines, why the numbers changed, and what this could mean for you.

The new guidelines

The American Heart Association, the American College of Cardiology, and 9 other professional health organizations updated the blood pressure guidelines based on their review of over 900 studies.

Adults are now considered to have high blood pressure if their numbers read 130/80 millimeters of mercury (mm Hg) and higher. Under the old guidelines, high blood pressure was considered 140/90 or higher. With these new guidelines, nearly half of the US population may be diagnosed with high blood pressure. This may leave you with questions, such as:

  • Why do I want to lower my blood pressure now that it’s considered to be high?
  • Does this mean I should start taking medicines to lower my blood pressure?

The new guidelines are based on evidence that a blood pressure reading of 130/80 or higher can pose serious health problems. Finding out you have high blood pressure does not mean you need to start taking medicine for it. It’s simply a warning for you to start to make some lifestyle changes to bring your blood pressure back down to a normal range.

Having a conversation earlier with your healthcare provider about prevention and lifestyle changes such as weight loss, healthy eating, and exercise to treat your blood pressure could help improve your health outcomes.

High blood pressure guidelines table

Blood pressure categories in the new guidelines are:

  • Normal: 120/80 mm Hg or lower.
  • Elevated: This used to be called “prehypertension.” The top number (systolic) is between 120 and 129 and the bottom number (diastolic) is 80 or lower. Elevated blood pressure can turn into high blood pressure if no action is taken. Recommendations for elevated blood pressure will likely include lifestyle changes.
  • High blood pressure is now split into two stages:

    Stage 1—130-139 for systolic or 80-89 for diastolic. In this stage, your healthcare provider may suggest that you make lifestyle changes to lower your blood pressure. Lifestyle changes may include eating healthy, exercising regularly, and losing weight. Depending on your risk for heart attack or stroke, he or she may also prescribe medicine.

    Stage 2—140 or above for systolic or 90 or above for diastolic. In this stage, your healthcare provider is likely to prescribe blood pressure-lowering medicine and lifestyle changes.

What you do can make a difference

There are many different things you can do to lower your high blood pressure in addition to making lifestyle changes. Check in regularly with your healthcare provider. He or she will monitor your blood pressure and make sure you are on track. Also, stay informed about your health by asking questions during your office visit. Here are some examples to help you get started:

  • I hadn’t been concerned about my blood pressure since it was below 140/90 mm Hg. What’s different now?
  • I’ve been doing well with my medication, but now my blood pressure is considered high based on the new guidelines. What do I need to do now?
  • If I’m at risk for heart disease, how does this affect my blood pressure treatment?
  • What lifestyle changes would be good for lowering my blood pressure?
  • How does sodium and salt affect my blood pressure? How much salt is safe for me to consume when I have high blood pressure?
  • What foods and drinks should I avoid?
  • How do I use my blood pressure cuff at home? How do I know if it’s accurate?
  • Do I need to see a dietitian?



  • 1. American Heart Association. Detailed Summary From the 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Accessed February 1, 2018.
  • 2. American Heart Association. Heart-Health Screenings. Accessed February 1, 2018.
  • 3. American College of Cardiology. High Blood Pressure Guidelines. Accessed February 1, 2018.
  • 4. American Heart Association. High blood pressure redefined for first time in 14 years: 130 is the new high. Accessed January 17, 2018.
  • 5. American Heart Association. How High Blood Pressure is Diagnosed. Accessed February 26, 2018.