Blood Pressure Classifications
When you have a blood pressure reading, the doctor will tell you two numbers: the SBP (systolic blood pressure) over the DBP (diastolic blood pressure). Use the following chart to compare your SBP and DBP numbers and classify your blood pressure. If your SBP and DBP fall into different categories, use the higher category. Note: mm Hg means millimeters of mercury.
| Category | SBP mm Hg | DBP mm Hg | |
|---|---|---|---|
| Normal | Less than 120 | and | Less than 80 |
| Prehypertension | 120–139 | or | 80–89 |
| High Blood Pressure | |||
| Stage 1 | 140–159 | or | 90–99 |
| Stage 2 | 160 or greater | or | 100 or greater |
What to Do after You Know Your Blood Pressure
After you’ve received your initial blood pressure measurement, follow these recommendations for follow up visits with your physician and any actions you may need to take if you have high blood pressure:
| SBP mm Hg | DBP mm Hg | Follow up Recommended |
|---|---|---|
| Under 120 | Under 80 | Recheck in two years |
| 120-139 | 80-89 | Recheck in one year; change lifestyle |
| 140-159 | 90-99 | Confirm in two months; one BP medication; change lifestyle |
| 160 or greater | 100 or greater | Treat within a month; two BP medications; change lifestyle |
How to Prevent or Reduce High Blood Pressure
If you’ve been diagnosed with prehypertension or high blood pressure, like millions of others, adopt these changes to help prevent, or lower, high blood pressure to a healthy level. Doing these things may prevent the harmful effects of high blood pressure:
- Make sure you definitely have high blood pressure by checking it several times.
- Look for the cause of the high blood pressure.
- Adopt the DASH diet.
- Reduce salt in your diet.
- Quit smoking.
- If you drink, limit alcohol intake.
- Cut down or eliminate your caffeine intake.
- Start an exercise program and stick with it.
- Use mind-body techniques such as yoga and meditation.
- Avoid medications that raise blood pressure like steroids, nonsteroidal anti-inflammatory agents, and certain diet pills.
- Take blood pressure medications without fail.
Evidence of Secondary High Blood Pressure
Secondary high blood pressure is a result of a specific illness. Usually, once the disease is treated, your blood pressure returns to normal. These signs may indicate you have secondary high blood pressure:
- Onset of high blood pressure before age 20 or past age 50
- Flushing spells
- Rapid pulse
- Intolerance to heat
- Very high level of blood pressure (over 180/120)
- Damage to the eyes, kidneys, or heart
- Low level of potassium in the blood
- Loud humming sound in the abdomen (called a bruit)
- Family history of kidney disease
- Poor response to treatment that’s usually effective
Assessing High Blood Pressure Drugs
If you’ve wholeheartedly made lifestyle changes trying to reduce your high blood pressure and it doesn’t seem to be working, you may need high blood pressure medication. Numerous drugs exist for high blood pressure, but you need to meet with your doctor to discuss what medicine is right for you. Drugs for high blood pressure fall into several classes:
- Angiotensin-converting enzyme (ACE) inhibitors: Lower blood pressure by blocking formation of a key hormone, angiotensin II, which both narrows arteries and causes release of another blood-pressure-raising hormone
- Angiotensin II receptor blockers: Lower blood pressure by preventing angiotensin II from attaching to a site
- Beta blockers: Lower blood pressure by decreasing the amount of blood pumped by the heart and by lowering the heart rate
- Calcium-channel blockers: Lower blood pressure by preventing calcium from entering cells, thus increasing the size of arteries
- Diuretics: Lower blood pressure by causing salt loss in the urine with accompanying body water, thereby reducing blood volume and pressure