Severe high blood pressure is referred to as malignant hypertension, in which the diastolic ("bottom") blood pressure reading is over 140 mmHg. Malignant hypertension is a medical emergency and can cause stroke. Symptoms can include nausea, severe headache, blurred vision, and dizziness. Some people with malignant hypertension may develop kidney failure. They may experience a decrease in urine output and swelling (edema), most pronounced in the lower legs.

Understanding the normal BP range with age can help the doctor and you to estimate your cardiovascular health. Blood pressure levels can fluctuate significantly from one reading to the next and it is important to remember that just one abnormally high reading does not signify that you have high blood pressure. Doctors usually use an average of multiple blood pressure readings taken over a period of several days to arrive at a diagnosis of high blood pressure.

Heart attack. Signs of heart attack include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm. Women may also have chest pain and pain down the left arm, but they are more likely to have less typical symptoms, such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw. Read more about the signs and symptoms of a heart attack.
A nurse takes your blood pressure at your annual physical. The numbers are recorded and the checkup continues. But do you know where on the blood pressure chart your levels are? Are they healthy? Too low? Too high, meaning you have hypertension? If you have high blood pressure or are heading in that direction, you should know that hypertension is among the primary enlarged heart causes, and a major risk factor for heart failure.
A blood pressure reading contains two numbers: systolic pressure and diastolic pressure. Systolic pressure is the top or first number in your blood pressure reading; it indicates the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number, and shows the pressure in your arteries while your heart is filling with blood.
Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks for high blood pressure than "pear-shaped" people.

You are considered to have hypertension if your systolic blood pressure measurements are between 130 and 139 or your diastolic measurement falls between 80 and 89. At this level of blood pressure you may not have any symptoms. When blood pressure reaches 180/120 or higher, a serious condition known as a malignant hypertension or hypertension crisis may occur. This can lead to stroke, kidney damage, heart attacks, or loss of consciousness. If you measure your blood pressure and it is this high, rest a few minutes and measure again. If it remains high, call 911.
Unfortunately, a problem doesn’t always announce itself with a fanfare of trumpets. Even the highest blood pressure can be entirely asymptomatic. Similarly, low blood pressure also known as hypotension can occur in your patient despite no symptoms seemingly being present. This is particularly true if the patient is lying still in an unmonitored bed. 

Our free blood pressure chart and blood pressure log allow you to track your blood pressure, aiding you in being aware of and gaining control over your blood pressure and health. Since normal blood pressure levels can change with age, weight, height and many other factors, you should consult your doctor or caregiver to determine your appropriate target blood pressure, which can be entered into the blood pressure log. The blood pressure charts below are a quick reference for low, normal and high blood pressures.
A person consistently showing blood pressure higher than 140/90 over several readings is considered to have hypertension. Doctors advise these people to make effective lifestyle changes to help lower their blood pressure, such as maintaining a healthy weight, including exercise in their daily routine, limiting salt and alcohol intake, and quitting smoking. The doctors will also recommend medication for hypertension depending on how much higher the BP is as compared to the normal blood pressure range and any other health problems that the patient faces.
^ Jump up to: a b Semlitsch, T; Jeitler, K; Berghold, A; Horvath, K; Posch, N; Poggenburg, S; Siebenhofer, A (2 March 2016). "Long-term effects of weight-reducing diets in people with hypertension". The Cochrane Database of Systematic Reviews. 3: CD008274. doi:10.1002/14651858.CD008274.pub3. PMID 26934541. Archived from the original on 23 March 2016. Retrieved 9 March 2016.
A sudden fall in blood pressure can be dangerous. A change of just 20 mm Hg — a drop from 110 systolic to 90 mm Hg systolic, for example — can cause dizziness and fainting when the brain fails to receive an adequate supply of blood. And big plunges, such as those caused by uncontrolled bleeding, severe infections or allergic reactions, can be life-threatening.
The brain requires unobstructed blood flow to nourish its many functions. Very high, sustained blood pressure will eventually cause blood vessels to weaken. Over time these weaken vessels can break, and blood will leak into the brain. The area of the brain that is being fed by these broken vessels start to die, and this will cause a stroke. Additionally, if a blot clot blocks a narrowed artery, blood ceases to flow and a stroke will occur.
Cirrhosis of the liver is the most common cause of portal hypertension. In cirrhosis, the scar tissue (from the healing of liver injury caused by hepatitis, alcohol, or other liver damage) blocks the flow of blood through the liver. Blood clots in the portal vein, blockages of the veins that carry blood from the liver to the heart, parasitic infection (schistosomiasis), and focal nodular hyperplasia are also causes of portal hypertension.
Although the guidelines do not change the traditional definition of high blood pressure, they do call for more aggressive treatment of the condition through the use of a combination of blood-pressure lowering medications. In fact, they say that most people with high blood pressure will require two or more drugs to achieve a blood pressure goal of less than 140/90. The blood pressure goal in people with diabetes or kidney disease should be less than 130/80.
Understanding the normal BP range with age can help the doctor and you to estimate your cardiovascular health. Blood pressure levels can fluctuate significantly from one reading to the next and it is important to remember that just one abnormally high reading does not signify that you have high blood pressure. Doctors usually use an average of multiple blood pressure readings taken over a period of several days to arrive at a diagnosis of high blood pressure.

Although it's most common in older adults, hypertension can also affect children. The normal blood pressure for a child is dependent upon the child's age, gender, and height. Your doctor can tell if your child's blood pressure is abnormal. Children are at higher risk for hypertension if they are overweight, African-American, or if they have a family history of the condition. Children with high blood pressure may benefit from the DASH diet and taking medications. Children with high blood pressure should also maintain a healthy weight and avoid tobacco smoke.
You begin by lying flat on a table. Straps are put around your body to hold you in place. After lying flat for awhile, the table is tilted to raise your body and head — simulating a change in position from lying down to standing up. During this test, your heart rate and blood pressure are monitored to evaluate your body's cardiovascular response to the change in position.

Health issues may happen; however, when a person's blood pressure suddenly drops and their brain is deprived of an adequate blood supply. The condition may lead to lightheadedness or dizziness. A sudden drop in blood pressure usually happens in a person who has risen from a prone or sitting position to a standing one. When this occurs it is referred to as, 'orthostatic hypotension,' or, 'postural hypotension.' Another type of low blood pressure may happen when a person stands for extended periods of time; it is referred to as, 'neurally mediated hypotension.'
Orthostasis literally means standing upright. Orthostatic hypotension, or postural hypotension, is defined as a decrease in systolic blood pressure of at least 20 mm Hg or at least 10mm Hg within 3 minutes of the patient standing. If orthostatic hypotension is present, the client may be at risk of falls and should be closely supervised with ambulation or advised to call for assistance with activity.
SOURCES: The Journal of the American Medical Association, May 21, 2003. Aram Chobanian, MD, dean, Boston University School of Medicine and chair of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Claude Lenfant, MD, director of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Edward Roccella, PhD, MPH, coordinator of the National High Blood Pressure Education Program at NHLBI. John Laragh, MD, Cardiovascular Hypertension Center at New York Hospital/Cornell University Medical Center and editor-in-chief of the American Journal of Hypertension. WebMD Medical News: "Diuretics Best for High Blood Pressure."

Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.
Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.

Medications used to lower blood pressure include diuretics (e.g., hydrochlorothiazide*), beta-blockers (e.g., atenolol, metoprolol), ACE inhibitors (e.g., ramipril, enalapril, lisinopril), calcium channel blockers (e.g., nifedipine, amlodipine), angiotensin II receptor blockers (e.g., losartan, valsartan), and direct renin inhibitors (e.g., aliskiren).
Blood pressure is measured with a blood pressure cuff (sphygmomanometer). This may be done using a stethoscope and a cuff and gauge or by an automatic machine. It is a routine part of the physical examination and one of the vital signs often recorded for a patient visit. Other vital signs include pulse rate, respiratory rate (breathing rate), temperature, and weight.

Low blood pressure is diagnosed by a doctor when they check your blood pressure with a sphygmomanometer. For people who experience low blood pressure without other symptoms, it may only require regular monitoring by a doctor during routine exams, and medical treatment may not be necessary. If certain signs suggest an underlying condition, your doctor may recommend one or more of the following tests to diagnose a cause for your hypotension:
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.

NHLBI Expert Panel on Cardiovascular Health and Risk Reduction in Children and Adolescents. We have supported the development of guidelines based on up-to-date research to evaluate and manage risk of heart disease in children and adolescents, including high blood pressure. Visit Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents for more information.
Blood pressure (BP) recordings consist of two numbers. The top one is the systolic blood pressure and relates to the contraction of the left side of the heart and the peak pressure achieved when it pumps blood round the body. The bottom number is the diastolic recording and is the lowest pressure achieved in the circulation; this relates to the relaxation of the heart. Blood pressure is measured in millimetres of mercury (mmHg), e.g. 120/70 mmHg.
Your total blood pressure reading is determined by measuring your systolic and diastolic blood pressures. Systolic blood pressure, the top number, measures the force your heart exerts on the walls of your arteries each time it beats. Diastolic blood pressure, the bottom number, measures the force your heart exerts on the walls of your arteries in between beats.
Blood pressure is assessed using two parameters -- the systolic and diastolic pressures -- which measure, respectively, the maximum pressure exerted in the arteries as the heart contracts, and the minimum pressure in those vessels between cardiac contractions. In adults, blood pressure is considered normal if the top number (systolic pressure) is between 90 and 120 and the bottom number (diastolic) is between 60 and 80.
There is no treatment available for the causes of portal hypertension. However, treatment can prevent or manage the complications. Diet, medication (nonselective beta-blockers), endoscopic therapy, surgery, and radiology procedures can all help in treating or preventing symptoms of portal hypertension. If these treatments are unsuccessful in treating symptoms, transjugular intrahepatic portosystemic shunt (TIPS) or distal splenorenal shunt (DSRA) are two procedures that may reduce pressure in the portal veins. Maintaining a healthy lifestyle may help to prevent portal hypertension.
The guidelines also outline very clearly when a diet-and-lifestyle approach is the recommended, first-line treatment, and when medications are simply just what you have to do. Thankfully, the decision is largely based on facts and statistics. For the elevated blood pressure category, medications are actually not recommended; rather, a long list of evidence-based, non-drug interventions are. What are these interventions? Things that really work: a diet high in fruits and vegetables (such as the DASH diet, which is naturally high in potassium); decreased salt and bad fats; more activity; weight loss if one is overweight or obese; and no more than two alcoholic drinks per day for men, and one for women. Simply changing what you eat can bring down systolic blood pressure by as much as 11 points, and each additional healthy habit you adopt can bring it down another four to five points.

^ Mente, Andrew; O'Donnell, Martin; Rangarajan, Sumathy; Dagenais, Gilles; Lear, Scott; McQueen, Matthew; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Li, Wei; Lu, Yin; Yi, Sun; Rensheng, Lei; Iqbal, Romaina; Mony, Prem; Yusuf, Rita; Yusoff, Khalid; Szuba, Andrzej; Oguz, Aytekin; Rosengren, Annika; Bahonar, Ahmad; Yusufali, Afzalhussein; Schutte, Aletta Elisabeth; Chifamba, Jephat; Mann, Johannes F E; Anand, Sonia S; Teo, Koon; Yusuf, S (July 2016). "Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies". The Lancet. 388 (10043): 465–75. doi:10.1016/S0140-6736(16)30467-6. PMID 27216139.
Imagine a garden hose hooked up to a spigot. When the hose is flexible and there are no kinks in it, you can turn on the water full blast and it will flow easily through the hose. But if there’s a kink in the hose, the water doesn’t flow as well beyond the kink. And the pressure inside the hose builds up behind the kink. Or imagine there is gunk inside the hose blocking the path of the water. Your arteries are a lot like that garden hose.
Blood pressure guidelines show the lower the blood pressure numbers the better. As long as no symptoms of trouble are present there is no one number that doctors consider being too low. The guidelines call for an individualized, risk-based approach to managing hypertension, as well as a personal consultation with a health care provider. While the new guidelines mean we are more aggressive about blood pressure control, lifestyle changes are always a part of the treatment plan. A treatment plan is agreed to by patient and provider, and includes ongoing communication to see how the patient is feeling and how their medications are working.
Hypertension, the medical term for high blood pressure, is known as "the silent killer." More than 80 million Americans (33%) have high blood pressure, and as many as 16 million of them do not even know they have the condition. If left untreated, high blood pressure greatly increases your risk for heart attack and stroke. Hypertension is projected to increase about 8 percent between 2013 and 2030.

How do you check your own blood pressure? It is common to have your blood pressure checked at the doctor's office, but there are many cases where it is important to monitor it at home. It is easy to check blood pressure with an automated machine, but it can also be done manually at home. Learn how to check your own blood pressure and what the results mean. Read now
Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results.[87] There is considerable evidence that reducing dietary salt intake lowers blood pressure, but whether this translates into a reduction in mortality and cardiovascular disease remains uncertain.[96] Estimated sodium intake ≥6g/day and <3g/day are both associated with high risk of death or major cardiovascular disease, but the association between high sodium intake and adverse outcomes is only observed in people with hypertension.[97] Consequently, in the absence of results from randomized controlled trials, the wisdom of reducing levels of dietary salt intake below 3g/day has been questioned.[96]
If your blood pressure remains high for a long period of time, you run the risk of damaging your blood vessels. Your stroke risk rises significantly, too. And because your heart is working harder to push blood through your system, that very valuable muscle can become overworked and grow thicker. An enlarged heart causes further complications, including heart failure. Medications and special implantable pumps can help boost heart function. But if you can manage your blood pressure before it gets too high and puts your heart at risk, you may be able to avoid a lot of complications down the road.
^ Mente, Andrew; O'Donnell, Martin; Rangarajan, Sumathy; Dagenais, Gilles; Lear, Scott; McQueen, Matthew; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Li, Wei; Lu, Yin; Yi, Sun; Rensheng, Lei; Iqbal, Romaina; Mony, Prem; Yusuf, Rita; Yusoff, Khalid; Szuba, Andrzej; Oguz, Aytekin; Rosengren, Annika; Bahonar, Ahmad; Yusufali, Afzalhussein; Schutte, Aletta Elisabeth; Chifamba, Jephat; Mann, Johannes F E; Anand, Sonia S; Teo, Koon; Yusuf, S (July 2016). "Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies". The Lancet. 388 (10043): 465–75. doi:10.1016/S0140-6736(16)30467-6. PMID 27216139.
^ Jump up to: a b Burt VL, Cutler JA, Higgins M, et al. (July 1995). "Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991". Hypertension. 26 (1): 60–69. doi:10.1161/01.HYP.26.1.60. PMID 7607734. Archived from the original on 2012-12-20. Retrieved 5 June 2009.

Heart attack. Signs of heart attack include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm. Women may also have chest pain and pain down the left arm, but they are more likely to have less typical symptoms, such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw. Read more about the signs and symptoms of a heart attack.

One side effect of diuretics is a loss of potassium, which is carried out of the body in urine along with the sodium. Potassium is needed for proper muscular movement and a deficiency of this mineral can result in fatigue, weakness, leg cramps, and even problems with the heart. So often, patients on traditional diuretics will be advised to take their medication with a potassium-rich food, such as orange juice or a banana, or they'll be prescribed a potassium supplement.


The new guidelines note that blood pressure should be measured on a regular basis and encourage people to use home blood pressure monitors. Monitors can range from $40 to $100 on average, but your insurance may cover part or all of the cost. Measure your blood pressure a few times a week and see your doctor if you notice any significant changes. Here are some tips on how to choose and use a monitor.
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
When blood pressure is measured, there are two numbers for each reading: for example, "120 over 80" is written as 120/80. This is because each heartbeat sends a pressure wave through the bloodstream. The higher number (systolic blood pressure) is the peak of the wave, when your heart contracts (the loud "thump" when you listen to your heartbeat). The lower number (diastolic blood pressure) is the lower "dip" or trough of the wave, when your heart relaxes. 
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