The Definition Of High Blood Pressure Is Changing

New guidelines from the American College of Cardiology and the American Heart Association have lowered the blood pressure readings at which hypertension is diagnosed in the United States.

The term ‘prehypertension’ has been scrapped, and instead the blood pressure levels previously referred to as ‘prehypertension’ have been divided into two new categories of:

  • Elevated BP if your upper reading (systolic pressure) is between 120 and 129 mmHg but your lower reading (diastolic pressure) remains less than 80 mmHg
  • Stage 1 hypertension if your systolic pressure is between 130 to 139 mmHg OR your diastolic pressure is between 80 to 89 mmHg.

So, if your blood pressure is anywhere between 130/80 mmHg or above you officially have hypertension.

The new blood pressure guidelines

The new definitions have come about because of increasing recognition that having an elevated blood pressure of 120/80 mmHg or more is associated with increased long-term health risks. Your artery walls receive a pounding every time your heart beats, which causes microdamage that slowly leads to hardening and furring up of the arteries. As a result, having an elevated blood pressure can double your long-term risk of a heart attack compared with someone whose blood pressure remains in the healthy range (ie below 120/80 mmHg).

Systolic BP

(lower reading)

Diastolic BP

(lower reading)

Older Definition

New US Definition

Less than 120 mmHg Less than 80 mmHg Normal BP Normal BP
120-129 mmHg Less than 80 mmHg


Elevated BP
130–139 mmHg 80–89 mmHg Stage 1 hypertension
140–159 mmHg 90–99 mmHg Stage 1 hypertension Stage 2 hypertension
> 160 mmHg >100 mmHg Stage 2 hypertension

The new guidelines mean the number of people diagnosed with high blood pressure will increase dramatically. With the old definition of hypertension, an estimated 31.9% of adults had hypertension – equivalent to 72,200,000 in the United States alone. With the new definition, an estimated 45.6% of adults have hypertension – 103,300,000 people, which is a massive jump.

Not everyone will need medication, however. Those now diagnosed with elevated blood pressure, or stage 1 hypertension will first be advised to follow diet and lifestyle changes, such as those feature on this website:

You will, however, be offered antihypertensive and other medication (such as a statin) if your underlying risk of a heart attack or stroke over the next ten years is calculated as 10% or higher.

The target for blood pressure management has also reduced from less than 140/90mmHg to a new treatment goal of achieving a blood pressure of less than 130/80 mmHg.

Click here to read about natural ways to lower a high blood pressure fast.

If your blood pressure is raised, self-monitoring is key to maintaining good control.

Click here for advice on choosing a blood pressure monitor to use at home.

See my recommended upper arm blood pressure monitors.

Image credit: pixabay

About DrSarahBrewer

Dr Sarah Brewer MSc (Nutr Med), MA (Cantab), MB, BChir, RNutr, MBANT, CNHC qualified from Cambridge University with degrees in Natural Sciences, Medicine and Surgery. After working in general practice, she gained a master's degree in nutritional medicine from the University of Surrey. Sarah is a registered Medical Doctor, a registered Nutritionist and a registered Nutritional Therapist. She is an award winning author of over 60 popular self-help books and a columnist for Prima magazine.

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