Understanding your blood pressure numbers

Blood pressure is written as two numbers — for example, 120/80. The first number (systolic) measures the pressure in your arteries when your heart beats. The second (diastolic) measures the pressure between beats, when your heart is at rest. Both numbers matter.

A normal reading for most adults is below 120/80. The range between 120/80 and 129/80 is now classified as elevated — not yet hypertension, but a signal that lifestyle changes are worth making before medication becomes necessary. Stage 1 hypertension starts at 130/80, and Stage 2 at 140/90 or higher.

A single high reading does not diagnose hypertension. Blood pressure fluctuates throughout the day based on stress, caffeine, exercise, and even the act of having your blood pressure taken in a clinic (known as white coat hypertension). Diagnosis typically requires elevated readings on at least two separate occasions.

What makes hypertension worth taking seriously is that it almost never causes symptoms. Most people with high blood pressure feel completely normal right up until the moment they have a heart attack or stroke. This is why it is called the silent killer, and why checking it regularly matters even when you feel fine.

If you have been told your blood pressure is elevated, there is a lot you can do before medication is considered. Reducing sodium, increasing physical activity, managing stress, cutting back on alcohol, and maintaining a healthy weight have all been shown to produce meaningful reductions. For some people, these changes are enough. For others, medication becomes necessary — and there is no shame in that. The goal is a number below 130/80, and we will work with you on the most realistic path to get there.