Two numbers, and what they mean
A blood pressure reading is written as two numbers, like 120/80 mm Hg. The top number, systolic, is the force of the blood as your heart pumps. The bottom number, diastolic, is measured between beats while the heart fills.2 Both numbers change through the day with what you are doing.3
Blood pressure categories for adults (mm Hg)
| Category | Top number (systolic) | And / or | Bottom number (diastolic) |
|---|---|---|---|
| Normal | Less than 1204 | and | Less than 80 |
| Elevated | 120 to 1294 | and | Less than 80 |
| High blood pressure, stage 1 | 130 to 1394 | or | 80 to 89 |
| High blood pressure, stage 2 | 140 or higher4 | or | 90 or higher |
| Hypertensive crisis | Higher than 1805 | or | Higher than 120 |
A diagnosis needs consistent readings: two or more, at separate appointments.7 Readings above 180/120 need immediate medical attention.5
For most adults, a healthy blood pressure is below 120/80. Consistent readings of 130 or higher on top, or 80 or higher on the bottom, count as high.6 The word that matters is consistent: a diagnosis needs two or more readings at separate appointments.7
In older adults a particular pattern is common: the top number is 130 or higher while the bottom stays below 80. This is called isolated systolic hypertension.39
Why you can't rely on how you feel
Half of American adults have high blood pressure, and many don't know it.1 About 1 in 3 U.S. adults who have it aren't aware of it and aren't being treated.9 The reason is simple: it often causes no signs you can see or feel.8
That is why NHLBI recommends a check at least once a year, and regular home monitoring as well.10
How to take a reading that means something
Small things move the number. Before a reading, skip exercise, coffee and cigarettes for 30 minutes, go to the bathroom, and sit quietly for at least 5 minutes.11 Keep your feet flat, don't talk, bare the arm, and rest it on a table at heart level.12 At home, keep your back supported and legs uncrossed.18
Taking a reading that means something
The same routine every time, at home or at a pharmacy.
Prepare
No exercise, coffee or cigarettes for 30 minutes. Go to the bathroom first.11
Sit for 5 minutes
Position
Back supported, feet flat, legs uncrossed, bare upper arm resting at heart level.1218
Measure twice
At least 2 readings, 1 minute apart, morning and evening.17
Record and share
Write down every reading for 5 days and report them to your provider.17
- The cuff. Readings can be different if the cuff is too small or too big.13 It should fit snugly, its bottom edge just above the elbow.21
- The device. Use an approved home monitor.16 Digital monitors are the best choice for most people, but an irregular heart rate makes the reading less accurate.19 Practice with your provider or nurse.20
- The log. At least 2 readings 1 minute apart, morning and evening, every day for 5 days — then share them.17
Home readings matter for another reason. Some people read high only in the provider's office — white coat hypertension.14 Others read lower in the office than they really are — masked high blood pressure, found by comparing office and home readings, especially at night.15
When the clinic and home disagree
White coat hypertension
Masked high blood pressure
What helps
Sodium is the clearest lever. Americans eat about 3,400 mg a day on average, against a recommended limit of less than 2,300 mg.37 Over 70% of it comes from packaged and prepared foods rather than the salt shaker, so the Nutrition Facts label is your best tool.36
Sodium per day, in milligrams
Average U.S. intake, the recommended limit, and the lower DASH level.
National figures and recommendations, not a measurement of any person or of a ProperHealth or Clarkson service.
The DASH eating plan needs no special foods; it sets daily and weekly goals, and at 1,500 mg of sodium it lowers blood pressure even further than at 2,300 mg.38
Weight and activity help too. Losing just 3% to 5% of your weight can improve blood pressure.26 Even 10 minutes of walking a day may help,27 working up to at least 150 minutes a week.28 For people who drink, keeping to no more than two drinks a day for men and one for women lowers the risk.29
Small changes with a measurable effect
When lifestyle changes alone don't control blood pressure, medicines do the rest, and many people need two or more.30 In the NIH SPRINT study, lowering systolic pressure to less than 120 in adults 50 and older significantly reduced cardiovascular disease and death.25
The clinic's approach
The Pakistan Institute of Medical Advancement in Karachi, whose documents inform this site, mentions blood pressure once, in a sheet about EDTA. Here is what it says, and what independent evidence shows.
The clinic's blood pressure claim, and the evidence
One clinic document mentions blood pressure. The clinic's words first, then independent evidence.
EDTA presented as something that "will control the blood pressure"
Listed in the clinic's treatment notesRegulator safety warning- Where the clinic says this
- Brochure set, page 4.40
- The clinic's stated rationale
- The sheet lists blood pressure among the conditions EDTA will control, next to opening blocked arteries.40
- Evidence and limitations
- None of the sources used here shows that EDTA lowers blood pressure. Chelation drugs need a prescription and a clinician's supervision; the FDA has never approved a chelation product for over-the-counter use, and it warns of dehydration, kidney failure and death, and of proven care being delayed.4142
- What this means for you
- Blood pressure medicines help prevent heart attack, stroke and kidney disease.24 Do not reduce or stop them in favor of chelation; ask your prescriber about anything new.32
A historical perspective: Dr. Majid Ali
“In most people, BP values change appreciably from hour to hour”
— Dr. Majid Ali, 15 December 2015
Dr. Ali questioned whether population thresholds map neatly onto individuals. One point in it is consistent with current guidance: a number is a measurement of a person on a day, not a verdict. Current guidance agrees that readings change through the day, and it rests a diagnosis on repeated readings.37
He also wrote critically of blood pressure medicines, proposed footsoaks and breakfast changes as remedies, and used a 'normal' range of his own. The sources used here do not support those: healthy is below 120/80 for most adults,6 and medication should be continued unless your doctor tells you to stop.32
Medicines that raise readings, and medicines that lower them
If your numbers changed recently, the cause may be on your medicine list. Antidepressants, decongestants, hormonal birth control pills and anti-inflammatory drugs such as aspirin or ibuprofen can all raise blood pressure.33 Over-the-counter drugs, vitamins and supplements can also affect your blood pressure and how well your medicine works.34
If a blood pressure medicine gives you side effects, say so: your provider may change the dose or give you a different medicine.31 Medication controls blood pressure but doesn't cure it, so keep taking it unless your doctor tells you to stop.32 If you feel dizzy when you stand, get up slowly; low blood pressure can make you lightheaded or faint.35
What to do this week
Check that your cuff fits
Readings can be different if the cuff is too small or too big.13 It should sit snugly, its bottom edge just above the elbow.21
Take one reading properly
No coffee, exercise or cigarettes for 30 minutes, an empty bladder, and 5 minutes sitting quietly first.11
Log morning and evening for 5 days
At least 2 readings, 1 minute apart, each time. Record them all and share them with your provider.17
Look at one sodium source
Most sodium comes from packaged and prepared foods; the Nutrition Facts label shows how much.36
Keep taking your medicine
Home readings inform your prescriber's decisions. Keep taking your medication unless your doctor tells you to stop.32
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- A reading above 180/120 with chest pain, trouble breathing, a sudden severe headache, numbness or weakness, a change in vision or trouble speaking — call 911. Do not wait to see if it comes down.434445
- Sudden face droop, arm weakness or speech difficulty — call 911. This can be a stroke.46
- A reading above 180/120 without symptoms — wait 5 minutes and check again; if it is still that high, call your healthcare provider.47
- Dizziness on standing that makes you unsteady — contact your prescriber; your blood pressure may be too low. Fainting, confusion, a weak and rapid pulse or cold skin — call 911.484950
- Your monitor repeatedly reports an irregular heartbeat — book an assessment; the readings may also be unreliable.5152
Every numbered marker links to the exact passage it rests on. Check the sources.