Whats the top number of blood pressure mean

WHEN SHOULD I WORRY ABOUT...

Dec. 11, 2019

In 2017, leading heart experts redefined high blood pressure for the first time in 14 years.

These blood pressure guidelines from the American College of Cardiology (ACC) and the American Heart Association give a lower definition of high blood pressure. According to the ACC, this new definition may result in nearly half of U.S. adults being diagnosed with the condition.

What is high blood pressure?

Blood pressure is a measurement of the force of your blood pushing against your blood vessel walls. High blood pressure, or hypertension, is diagnosed when that pressure is consistently too high.

Your systolic pressure (the top number of your reading) is the pressure in the arteries as the heart beats. Your diastolic pressure (the bottom number of your reading) is a measurement of the pressure in the arteries as the heart muscle rests.

“Typically, the top number receives more attention, but elevated diastolic pressure alone also increases cardiovascular disease risk,” says Dr. Irfan Dadabhoy, a primary care physician at Houston Methodist.

Under the new guidelines there are now five categories of blood pressure. The prehypertension category has been removed from the guidelines.

Why it’s important to have your blood pressure checked

“High blood pressure is sometimes called a ‘silent killer’ because it doesn’t cause symptoms and won’t be caught without regular blood pressure readings,” explains Dr. Dadabhoy. “Having high blood pressure makes you four times more likely to die from a stroke and three times more likely to die from heart disease, according to the Centers for Disease Control and Prevention (CDC).”

Dr. Dadabhoy says that the only way to know whether you have high blood pressure is to have it checked. Most likely, your blood pressure is measured and recorded every time you go to your health care provider’s office. And, keep in mind, just because you feel "healthy" doesn't mean you can ignore your doctor's warnings about elevated blood pressure. Everyone's blood pressure matters, even if you're young.

It's important to talk with your doctor about the new high blood pressure guidelines and how they may impact treatment for your personal health situation. The goal is that by defining high blood pressure at a lower threshold, people will start working with their health care providers sooner to find ways to successfully manage the condition through lifestyle changes.

Tips for managing high blood pressure

“There’s no cure for high blood pressure, but you can successfully manage it with medication and living a healthy lifestyle,” Dr. Dadabhoy says.

The following changes can help you better manage high blood pressure:

  • Monitoring your blood pressure regularly
  • Taking your medications as prescribed
  • Eating a well-balanced, low-salt diet
  • Exercising regularly
  • Maintaining a healthy weight that you and your doctor have agreed on
  • Quitting smoking
  • Increasing potassium intake, if recommended by your doctor
  • Managing stress
  • Limiting alcohol

Blood pressure is a measure of the force that your heart uses to pump blood around your body.

How is blood pressure measured?

Blood pressure is measured in millimetres of mercury (mmHg) and is given as 2 figures:

  • systolic pressure – the pressure when your heart pushes blood out
  • diastolic pressure – the pressure when your heart rests between beats

For example, if your blood pressure is "140 over 90" or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.

As a general guide:

  • ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
  • high blood pressure is considered to be 140/90mmHg or higher
  • low blood pressure is considered to be 90/60mmHg or lower

High blood pressure

High blood pressure is often related to unhealthy lifestyle habits, such as smoking, drinking too much alcohol, being overweight and not exercising enough.

Left untreated, high blood pressure can increase your risk of developing a number of serious long-term health conditions, such as coronary heart disease and kidney disease.

Low blood pressure

Low blood pressure is less common. Some medicines can cause low blood pressure as a side effect. It can also be caused by a number of underlying conditions, including heart failure and dehydration.

Further information:

  • Cardiovascular disease (CVD) 
  • Blood pressure test
  • Keep your blood pressure healthy
  • Blood Pressure UK
  • British Heart Foundation

Page last reviewed: 17 September 2019
Next review due: 17 September 2022

What does it mean when the top number of your blood pressure is elevated?

If you have a blood pressure reading that is above 180 in the top number or above 120 in the bottom number, you may be having a hypertensive crisis, which is a medical emergency. Blood pressure this high can damage your blood vessels and could lead to a stroke.

What is a good number for the top number of your blood pressure?

For a normal reading, your blood pressure needs to show: a systolic pressure that's above 90 mm Hg and less than 120 mm Hg, and. a diastolic pressure that's between 60 mm Hg and less than 80 mm Hg.

What's more important the top or bottom number of blood pressure?

Q. When I am monitoring my blood pressure, which number is most important — top, bottom, or both? A. While both numbers in a blood pressure reading are essential for diagnosing and treating high blood pressure, doctors primarily focus on the top number, also known as systolic pressure.