Blood Pressure

Last Updated: July 19, 2023

Blood pressure is the force that blood exerts on blood vessels as it circulates. High blood pressure (hypertension) and low blood pressure (hypotension) can each lead to a variety of health issues.

Overview

Blood pressure (BP) refers to the force that blood exerts on the blood vessels as it circulates through your body. It plays a central role in heart health: cardiovascular disease risk is strongly associated with an increase in blood pressure, even when BP is within normal range.[1][2]

As your blood pressure increases, it strains your blood vessels and heart. If it remains too high (hypertension), this can increase your risk for heart attacks, strokes, vascular diseases, eye damage, kidney disease, and more.

As your BP drops, the pressure on the blood vessel walls decreases. If it remains too low (hypotension), you may not get enough oxygen to critical parts of your body, such as the brain and heart.

There are multiple risk factors that can contribute to the development of high blood pressure.

  • Age: As you age, blood pressure tends to go up.
  • Family history: Nearly 100 genetic variations have been associated with high blood pressure. While a family history of high BP raises your risk, the exact pattern of genetic inheritance is not known.
  • Lifestyle: Too much sodium (salt), insufficient potassium, not enough exercise, excessive alcohol intake, and smoking can all contribute to high blood pressure.
  • Race/ethnicity: Black adults experience high blood pressure more frequently.
  • Sex: Prior to age 55, males are more likely to develop high blood pressure. After 55, females are more likely to develop it.
  • Weight: People who carry too much fat have an increased risk of high blood pressure.

How are blood pressure levels assessed?

Blood pressure is most commonly measured using a blood pressure monitor or gauge (where a cuff is placed around your upper arm). It can be measured either in a single sitting or via ambulatory blood pressure monitoring (ABPM) over 24 hours with a leave-on cuff. The latter is likely to be more accurate and result in fewer anomalous measurements since blood pressure can naturally fluctuate throughout the day.

Blood pressure is reported in two numbers; e.g., 120/80 mmHg (millimeters of mercury — a unit of pressure).

  • The first number, systolic blood pressure, tells us how much pressure your blood is exerting against the arterial walls when your heart contracts.
  • The second number, diastolic blood pressure, signifies how much pressure your blood is exerting when the heart is relaxed and refilling with blood.

Blood pressure measurements are generally divided into the five categories below.

Blood pressure category cutoffs (mmHg)

CATEGORYSYSTOLICDIASTOLIC
Low blood pressure
≤90
≤65
Normal blood pressure
<120
<80
Elevated blood pressure
120–129
<80
Stage 1 hypertension
130–139
80–89
Stage 2 hypertension
≥140
≥90

Adapted from Whelton et al. Hypertension. 2018.[3]

In adults 65 or older, a blood pressure goal of 125–130 systolic and <80 diastolic is recommended.

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References
  1. ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
  2. ^Pei D, Chen YL, Tang SH, Wu CZ, Lin JD, Chang YL, Hsu CH, Wang CY, Wang K, Wang JYRelationship of blood pressure and cardiovascular disease risk factors in normotensive middle-aged menMedicine (Baltimore).(2011 Sep)
  3. ^Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesHypertension.(2018 Jun)
  4. ^Peti-Peterdi J, Harris RCMacula densa sensing and signaling mechanisms of renin releaseJ Am Soc Nephrol.(2010 Jul)
  5. ^Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM, American Heart AssociationDietary approaches to prevent and treat hypertension: a scientific statement from the American Heart AssociationHypertension.(2006 Feb)
  6. ^National High Blood Pressure Education ProgramThe Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
  7. ^Tielemans SM, Altorf-van der Kuil W, Engberink MF, Brink EJ, van Baak MA, Bakker SJ, Geleijnse JMIntake of total protein, plant protein and animal protein in relation to blood pressure: a meta-analysis of observational and intervention studiesJ Hum Hypertens.(2013 Sep)
  8. ^Rebholz CM, Friedman EE, Powers LJ, Arroyave WD, He J, Kelly TNDietary protein intake and blood pressure: a meta-analysis of randomized controlled trialsAm J Epidemiol.(2012 Oct 1)
  9. ^Fekete ÁA, Giromini C, Chatzidiakou Y, Givens DI, Lovegrove JAWhey protein lowers blood pressure and improves endothelial function and lipid biomarkers in adults with prehypertension and mild hypertension: results from the chronic Whey2Go randomized controlled trialAm J Clin Nutr.(2016 Dec)
  10. ^Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesHypertension.(2018 Jun)
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