When Is Your Blood Pressure Too High?

High blood pressure comes in several stages, and knowing the difference between an occasional elevated reading, consistent hypertension, and an extremely high spike that indicates an emergency is essential.

This knowledge will ensure that you can successfully manage your high blood pressure and prevent more significant health problems.

Here is an overview of what to look for when evaluating your blood pressure for potential signs of more serious health problems.

How to understand and interpret blood pressure readings

Knowing what your numbers mean is a key step in keeping track of your overall health, especially if you are monitoring your blood pressure at home.

Even if your blood pressure is not high enough to make a daily check necessary, it is still a good idea to understand what the reading numbers mean on their own and how their fluctuation may affect your overall health over time.

What do the numbers mean?

Your blood pressure readings are divided into two distinct numbers written as an upper number over a lower number. These numbers are called the systolic number and the diastolic number.

The systolic number, which is found on top of the reading, is the larger number, while the diastolic number is smaller and located on the bottom.

Both numbers are measured in mm Hg, which means millimeters of mercury. Although mercury is not currently involved in the process, it was used as part of the original device that measured blood pressure, and the name has not changed since.

The numbers identify two different aspects of the amount of pressure that the blood flowing through your arteries puts on your arteries' walls.

The systolic number refers to the higher amount of pressure that your blood puts on the walls of your arteries when your heart beats. It is generally considered more important when monitoring and diagnosing the various categories of high blood pressure.

The diastolic number refers to the amount of pressure that your blood puts on the walls of your arteries in between heart beats. Although this number is still useful, it is more important that your systolic number is within a reasonable range.

What these numbers mean for your overall health

Understanding what your blood pressure numbers mean is essential, but it is also important to know what readings might indicate changes in your health or a need to contact your physician about a potential emergency.

Several factors can impact what is considered normal blood pressure, such as your age, gender, or other health problems.

• Normal: For most people, your systolic number should fall at or below 120mm Hg, and your diastolic number should be at or below 80mm Hg to be considered normal.

• Elevated: A systolic number that falls between 121-129mm HG is typically considered elevated for most people, but this is often temporary and not a cause for concern as long as the diastolic number is still at or below 80mm Hg.

Your blood pressure may temporarily become elevated in response to a specific event or situation that makes you angry, frustrated, irritated, frightened, or otherwise stressed out.

Elevated blood pressure should, under most circumstances, return to normal after the stressful situation passes. For this reason, occasional readings within this range that do not stay there are not necessarily an indicator of an underlying problem that should be a reason to be concerned.

However, numbers that are higher or do not return to normal may be a warning sign that you need to start making specific lifestyle changes to keep your blood pressure under control. This can help lower your risk of heart disease, stroke, or other serious health problems.

Blood pressure readings higher than a systolic number of 129mm Hg or a diastolic number of 80mm HG typically indicate stage I hypertension, stage II hypertension, or a hypertensive crisis.

You should work with your doctor to manage blood pressure that falls within the ranges of stage I or stage II hypertension. 

You should immediately visit an emergency room if you experience a reading that indicates a hypertensive crisis because this is often a life-threatening condition.  

Normal blood pressure ranges 

A wide range of factors help determine a normal blood pressure range for any particular person, and there is no one-size-fits-all approach.

Your age and gender play significant roles in determining approximately where your blood pressure should fall if you are healthy overall. Your genetics, lifestyle choices, and other health concerns can also impact your blood pressure. 

Blood pressure ranges by age

The body's precise needs, capabilities, and functions change over time, which means that it is important to consider age when determining an acceptable, concerning, or dangerous range of blood pressure.

Blood pressure ranges that are considered "normal" can increase as we age. Like many health conditions, older adults are at a higher risk of developing high blood pressure and experiencing complications that may be connected. This generally happens because arteries can stiffen over time and plaque buildup within the arteries gradually reduces the amount of space your blood has to move through. 

This means that readings that would not indicate a problem for adults may be more concerning in teens or young adults. However, high blood pressure numbers can be concerning at any age.

For example,¹ men between the ages of 21-25 should typically have a blood pressure of approximately 120.5/78.5mm Hg, and this figure can rise to around 143.5/76.5mm Hg and still be considered normal by age 61-65.

For women, typical blood pressure should be approximately 115.5/70.5mm Hg at age 21-25 and 130.5/77.5mm Hg at age 61-65.

Although each of these age brackets typically covers approximately five years, the specific timeline is not set in stone and can vary from person to person.  

Blood pressure ranges by gender

Although normal blood pressure ranges tend to fall relatively close together for men and women, they can vary slightly.

In general, men often tend to have a slightly higher blood pressure than women of the same age, although other health conditions can also contribute to elevated blood pressure. 

When is blood pressure considered too high or dangerous? 

Although your blood pressure readings give a relatively good idea of when high blood pressure may become dangerous, knowing how high is too high is more complicated than the numbers alone.

Knowing which category of high blood pressure your numbers usually fall into and what may be considered out of the ordinary is important for understanding what is considered dangerously high. 

Categories of high blood pressure 

"High blood pressure" is not an all-encompassing health problem that always comes with the same level of concern.

Like many medical conditions, the broader condition of high blood pressure is divided into specific categories with increasingly new or more severe symptoms.

Determining whether high blood pressure is a minor concern or an immediate concern that could quickly become life-threatening requires determining which category your situation falls into.  

Elevated blood pressure 

Under most circumstances, elevated blood pressure is not considered to be particularly dangerous on its own because the condition is often temporary and won’t cause significant harm.

However, your doctor may be concerned if you frequently have elevated blood pressure with no apparent reason or if you have other health problems, as it could indicate that you are developing hypertension. 

Hypertension stage I

Blood pressure levels that rise above a systolic number of 130mm Hg or a diastolic number of 80mm Hg likely indicate the beginning of hypertension, or high blood pressure, especially if they are consistently above this level.

Hypertension is divided into two stages based on the systolic and diastolic numbers you most frequently experience. Progressing into stage II is generally an indication of a more serious condition than stage I.

Systolic numbers that fall between 130-139mm Hg or diastolic numbers that fall between 80-89mm Hg generally indicate hypertension stage I. Still, it is important to note that this is not always true, and your specific case must be evaluated and diagnosed by a medical professional.

Hypertension stage II

Hypertension stage II encompasses the next category of high blood pressure. This stage is often more likely to lead to heart problems, stroke, or other serious health concerns.

Stage II typically involves systolic numbers of 140mm Hg or higher or diastolic numbers of 90 or higher. Once you reach these minimums, even occasional numbers at one or both of these levels are concerning.

Hypertensive crisis

A hypertensive crisis is the most serious category of high blood pressure. This phase can become life-threatening very quickly if it is not treated immediately.

This type of high blood pressure typically involves a fast and sharp spike in blood pressure, while hypertension tends to rise more slowly and does not reach a level that is as high as a hypertensive crisis.

If you experience a hypertensive crisis, your blood pressure may reach systolic levels of 180mm Hg or diastolic levels of 120mm Hg very suddenly. You may also suddenly experience shortness of breath, chest pain, back pain, numbness or weakness, difficulty speaking, or changes in vision.

It is also possible for both of your numbers to rise above these minimums, which can be extremely dangerous, especially if you are also experiencing multiple other symptoms.

When to seek emergency care

You should contact your physician or visit an emergency room immediately if you are experiencing a hypertensive crisis. This type of high blood pressure escalates quickly and may not leave you with much time to seek medical treatment.

Lifestyle and health concerns that can contribute to high blood pressure 

Your age, gender, and genetics may affect your overall blood pressure and make you more susceptible to high blood pressure in ways that you cannot control.

However, there are also several ways your lifestyle choices may negatively affect your blood pressure and overall health.

Obesity, smoking, and poor dietary choices can be harmful to several aspects of your health, including blood pressure.

Making changes to these areas of your life can help improve your overall health and lower your average blood pressure.

Your doctor may recommend losing weight, eating better, and quitting smoking. These changes can be combined with medications or other treatment options to help get your blood pressure to a healthier range.

Obesity

Obesity is a significant risk factor for those who may be the most at risk for developing complications related to high blood pressure.

Being slightly overweight does not mean that you are automatically likely to develop high blood pressure, especially if you are otherwise relatively healthy and do not have any other major risk factors. However, significant obesity tends to be a major contributing factor for men and women.

Older men and women tend to experience a more significant link between obesity and high blood pressure, but it can be a risk factor at any age.

Consuming too much salt can increase your blood pressure on its own, and this link may be even more significant if your weight makes it more difficult for your body to get rid of excess salt within a normal amount of time.

Excess caffeine or alcohol intake can likewise raise your blood pressure levels.

Smoking 

Smoking is another common risk factor for developing high blood pressure. Although any amount of smoking can elevate your overall level of risk for experiencing high blood pressure that could eventually become dangerous, older individuals that have been heavy smokers throughout the majority of their lives tend to be most at risk.

Heavy smokers are also among the most likely to develop heart disease, which often goes hand-in-hand with high blood pressure.

Smoking causes plaque (fat) to build up within the arteries, which your blood must then fit through a tighter space, increasing the overall pressure of your blood against the edges of your arteries.

This buildup of plaque occurs over time and can get worse the longer you smoke, and each cigarette also temporarily increases your blood pressure at that moment.

Unhealthy diet

Maintaining a healthy diet is vital for improving your overall health, and poor nutritional choices can cause you to develop high blood pressure, heart disease, and similar health conditions.

Foods high in salt are especially likely to contribute to high blood pressure because consuming too much salt may cause your body to retain an excessive amount of water to wash that salt out of your cells. This excess water can put a higher level of stress on your heart and blood vessels, leading to other heart problems.

Incorporating a variety of fruits, vegetables, and other low sodium foods is an important step in creating a diet that can help you improve your blood pressure and heart health.

Health conditions that can contribute to high blood pressure 

Other health conditions can make you more likely to develop high blood pressure, and high blood pressure can worsen other health conditions.

Some health conditions that may increase your blood pressure include diabetes, kidney disease, and obstructive sleep apnea.

Understanding how these conditions may affect your blood pressure and whether any medications you take may interact is essential for successfully managing both problems.

What can you do to lower your blood pressure immediately? 

Seeing a doctor as soon as possible after experiencing extremely high blood pressure is important. You can also take several steps to quickly lower your blood pressure to improve your immediate safety.

Lying flat on your back and taking slow, deep breaths can help you feel calmer and lower your blood pressure, especially if the spike was related to a frightening, frustrating, or otherwise unusually stressful situation. 

When should you see a doctor?

High blood pressure is often an ongoing condition, and not every reading above a normal range requires an immediate visit to your doctor.

However, several warning signs may indicate you will not be able to get your blood pressure back under control without a doctor's assistance, or that waiting too long may lead to a heart attack, stroke, or other serious medical problem.

You should call your doctor or visit an emergency room immediately if you experience a reading that is much higher than usual (especially if this number is higher than 180/120mm Hg) or if you suddenly experience blurred vision, a severe headache, dizziness or lightheadedness, or difficulty breathing.

The lowdown

Although some people may experience high blood pressure as an ongoing condition that doesn’t require medical intervention, it can become much more serious over time or with little to no warning.

Keeping your blood pressure controlled through medications, lifestyle changes, and regular monitoring can help keep your high blood pressure from causing more significant problems.