New guidelines from the American Heart Association and the American College of Cardiology announced last week revised the reading at which high blood pressure is diagnosed from 140/90 to 130/80.  This change increased the number of Americans with high blood pressure from about a third to almost half of all adults. Previous guidelines had a systolic reading of 130-139 as pre-hypertension or pre-high blood pressure. The new guidelines move pre-hypertension to 120-129 and normal to less than 120. These changes are expected to triple the number of men under the age of 45 diagnosed with high blood pressure, and double the number of women.

The good news is that not everyone with high blood under the new guidelines should be treated with drugs, only those with known heart disease. For everyone else, the recommended treatment is lifestyle modification – lower sodium intake, weight loss, and a diet with more fruits, vegetables and whole grains.

From the American College of Cardiology - Blood pressure categories in the new guideline are:
(systolic = top number, diastolic = bottom number)

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  • Normal: Less than 120/80 mm Hg;
  • Elevated: Systolic between 120-129 and diastolic less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

Complete guidelines:

Summary from National Institute of Health -National Library of Medicine:


For more information:

American Heart Association

Centers for Disease Control and Prevention