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Knowing Your Numbers: What the New Blood Pressure Guidelines Mean

Kristen Nichols HeitmanThis is a guest post by Kristen Nichols Heitman, MPH, an epidemiologist in the Rickettsial Zoonoses Branch in the Division of Vector-Borne Diseases in the National Center for Emerging Zoonotic and Infectious Diseases at the Centers for Disease Control and Prevention (CDC). She received a Master of Public Health (MPH) with a concentration in epidemiology from Georgia State University.

During your last annual physical, were you on the cusp of being diagnosed with hypertension, also known as high blood pressure? Well, don’t be surprised if you are diagnosed this year. The American College of Cardiology and the American Heart Association recently released their updated blood pressure guidelines – making the diagnostic guidelines stricter. Under the previous guidelines, normal blood pressure was  characterized as being less than 140/90. Under the new guidelines, normal blood pressure must be less than 120/80. This means around half of Americans will now be considered to have high blood pressure. The hope with making the guidelines stricter is that those diagnosed with high blood pressure will address the deadly condition sooner. The table below outlines the new blood pressure diagnostic categories.

New guidelines (systolic/diastolic)
Normal blood pressure120/80 and under
Elevated blood pressure (previously known as “pre-hypertension”)120–129 systolic
Stage 1 high blood pressure (hypertension)130–139 systolic or 80–89 diastolic
Stage 2 high blood pressure (hypertension)140+ systolic or 90+ diastolic

Blood pressure is typically recorded as two numbers and written as a ratio. The top number is systolic pressure, which is also the higher of the two numbers. It measures the pressure in the arteries when the heart beats (when the heart muscle contracts). The bottom number shows diastolic pressure, the lower of the two numbers. It measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood). Blood pressure is checked through a quick, painless test using a blood pressure cuff – also known as a sphygmomanometer. You can complete the test at a doctor’s office, employer wellness event, pharmacy, or at home.

But it’s not as easy as just checking the table. There is now a six-step tutorial on how to correctly measure blood pressure, including measuring the blood pressure carefully on at least two different occasions. If you do fall into the hypertension category using the new guidelines, there are statistics-based guidelines on interventions ranging from lifestyle changes, including diet and exercise, to medication. 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.

Research shows a clear link between high blood pressure and cardiovascular disease. A 20-point higher systolic blood pressure or a 10-point higher diastolic blood pressure is associated with doubling your risk of death from a heart attack, stroke, or other cardiovascular complication. High blood pressure often shows no signs or symptoms, which is why it’s so important to have yours checked regularly.

While the hypertension diagnostic guidelines may have changed, ways for preventing high blood pressure has not. A lifestyle with a healthy diet (fresh fruit and vegetables, fiber-rich whole grains, fish, nuts, legumes and seeds) and at least 30 minutes of physical activity each day can go a long way for preventing high blood pressure. Ask your doctor how often you should be seen for a routine checkup and make sure you to address any health concerns or questions you may have during the appointment. Maintaining a healthy body weight can decrease your risk of hypertension too. Talk to your doctor and use a BMI chart to determine a healthy weight for you. Reducing the amount of alcohol intake, stopping smoking, lowering stress levels and decreasing sodium intake can all also lead to lower blood pressure.


Whelton PK, Carey RM, Aronow WS, Casey Jr DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith Jr SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams Sr KA, Williamson JD, Wright Jr JT, 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary, Journal of the American College of Cardiology (2017), doi: 10.1016/j.jacc.2017.11.005.

The conclusions, findings, and opinions expressed by the author do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

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