According to the American Heart Association, normal blood pressure for adults (ages 20 and older) is less than 120/80 mm Hg.
The American College of Cardiology (ACC) and the American Heart Association (AHA) updated their guidelines in 2017 to recommend men and women who are 65 or older aim for a blood pressure lower than 130/80 mm Hg.
The new blood pressure categories.
- Normal = less than 120 and less than 80.
- Elevated = 120-129 and less than 80.
- High Blood Pressure Stage 1 = 130-139 or 80-89.
- High Blood Pressure Stage 2 = 140 or higher or 90 or higher.
- Hypertensive Crisis (call your doctor immediately) = Higher than 180 and/or higher than 120.
The definition for what is considered high blood pressure has been tightened. Here's what you need to know.
If you didn't have high blood pressure before, there's a good chance you do now.
In 2017, new guidelines from the American Heart Association, the American College of Cardiology, and nine other health organizations lowered the numbers for the diagnosis of hypertension (high blood pressure) to 130/80 millimeters of mercury (mm Hg) and higher for all adults. The previous guidelines set the threshold at 140/90 mm Hg for people younger than age 65 and 150/80 mm Hg for those ages 65 and older.
This means 70% to 79% of men ages 55 and older are now classified as having hypertension. That includes many men whose blood pressure had previously been considered healthy. Why the change?
Behind the numbers
"Blood pressure guidelines are not updated at regular intervals. Instead, they are changed when sufficient new evidence suggests the old ones weren't accurate or relevant anymore," says Dr. Paul Conlin, an endocrinologist with Harvard-affiliated VA Boston Healthcare System and Brigham and Women's Hospital. "The goal now with the new guidelines is to help people address high blood pressure — and the problems that may accompany it like heart attack and stroke — much earlier."
The new guidelines stem from the 2017 results of the Systolic Blood Pressure Intervention Trial (SPRINT), which studied more than 9,000 adults ages 50 and older who had systolic blood pressure (the top number in a reading) of 130 mm Hg or higher and at least one risk factor for cardiovascular disease. The study's aim was to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior to the standard target of 140 mm Hg or less. The results found that targeting a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period.
More than blood pressure
The new guidelines have other changes, too. First, they don't offer different recommendations for people younger or older than age 65. "This is because the SPRINT study looked at all patients regardless of age and didn't break down groups above or below a certain age," says Dr. Conlin.
The guidelines also redefined the various categories of hypertension. It eliminated the category of prehypertension, which had been defined as systolic blood pressure of 120 to 139 mm Hg or diastolic pressure (the lower number in a reading) of 80 to 89 mm Hg. Instead, people with those readings are now categorized as having either elevated pressure (120 to 129 systolic and less than 80 diastolic) or Stage 1 hypertension (130 to 139 systolic or 80 to 89 diastolic).