A good blood pressure reading is below 120/80 mm Hg. That means the top number (systolic) is under 120 and the bottom number (diastolic) is under 80. Anything in this range is classified as normal, and it’s the target for most adults regardless of age.
What the Two Numbers Mean
Blood pressure is always written as two numbers separated by a slash. The top number, systolic pressure, measures the force on your artery walls each time your heart squeezes and pushes blood out. The bottom number, diastolic pressure, measures the force when your heart relaxes between beats. Both numbers matter, but systolic pressure tends to get more attention because it rises with age and is a stronger predictor of heart disease in people over 50.
The unit of measurement, millimeters of mercury (mm Hg), is a holdover from the days when blood pressure was measured with a column of liquid mercury. You don’t need to think about it. Just pay attention to the numbers.
Blood Pressure Categories
The 2025 guidelines from the major heart organizations break blood pressure into four categories:
- Normal: below 120 systolic and below 80 diastolic
- Elevated: 120 to 129 systolic and below 80 diastolic
- Stage 1 hypertension: 130 to 139 systolic or 80 to 89 diastolic
- Stage 2 hypertension: 140 or higher systolic or 90 or higher diastolic
Notice the word “or” in the hypertension stages. If either number crosses the threshold, the higher category applies. So a reading of 125/92 counts as stage 1 hypertension because the bottom number is in the 80 to 89 range, even though the top number looks fine.
Elevated blood pressure is a warning zone. It means your arteries are under more pressure than ideal, but you haven’t crossed into hypertension yet. Without changes, elevated readings typically progress to stage 1 hypertension within a few years.
Targets for Older Adults
For years, some physicians believed that people over 65 could safely tolerate systolic readings up to 150. That thinking has shifted. Current guidelines recommend that most adults, including older adults, aim for a systolic reading below 130.
A 2025 review of four randomized controlled trials looked at over 3,600 people ages 75 and older. Those who brought their systolic pressure below 130 had a 39% lower risk of cardiovascular events like heart attack, stroke, and heart failure compared to those who aimed for a looser target between 130 and 150. They also had a 45% lower risk of dying from cardiovascular causes. The more aggressive target did not increase rates of falls, fractures, dangerously low blood pressure, or cognitive decline.
When Blood Pressure Is Too Low
A reading below 90/60 mm Hg is generally considered low blood pressure, or hypotension. But low blood pressure is only a concern if it causes symptoms. Some people naturally run low and feel perfectly fine at 85/55.
Symptoms that signal a problem include dizziness, lightheadedness, fainting, blurred vision, nausea, and unusual fatigue. These happen because not enough blood is reaching your brain and other organs. If you consistently feel dizzy when standing up or notice these symptoms alongside a low reading, that’s worth investigating.
When a Reading Is Dangerously High
A reading of 180/120 mm Hg or higher is a hypertensive crisis. If you see this number on your monitor, sit quietly for five minutes and measure again. If it’s still at or above 180/120, and especially if you’re experiencing symptoms like severe headache, chest pain, blurred vision, confusion, nausea, or seizures, call emergency services. These symptoms can indicate organ damage in progress.
A reading at that level without symptoms is still serious. It’s called an urgent hypertensive crisis and needs same-day medical attention, even if you feel okay.
How to Get an Accurate Reading
A single blood pressure reading can be misleading. Stress, caffeine, a full bladder, even the act of rushing to sit down can temporarily spike your numbers. The way you take the measurement matters as much as the number itself.
Sit in a comfortable chair with your back supported for at least five minutes before taking a reading. Rest the arm wearing the cuff on a table so it’s level with your chest. Place the cuff on bare skin, not over a sleeve. Keep your feet flat on the floor, legs uncrossed. Don’t talk during the measurement.
For a reliable picture, take two readings one minute apart and average them. Do this at the same time each day, ideally morning and evening, for at least three days before drawing conclusions. A single high reading at a pharmacy kiosk doesn’t mean you have hypertension, and a single normal reading at home doesn’t mean you’re in the clear.
What Affects Your Numbers Day to Day
Blood pressure isn’t static. It fluctuates throughout the day based on activity, stress, hydration, sleep, and even the temperature. It’s typically lowest while you sleep and rises sharply in the morning. Exercise temporarily raises it, but regular physical activity lowers your baseline over time. Alcohol, caffeine, and a high-sodium meal can all push readings up for hours.
“White coat hypertension” is a well-documented phenomenon where people show elevated readings in a clinical setting but normal readings at home. The reverse also happens: some people have normal readings at the doctor’s office but elevated readings the rest of the time, a pattern called masked hypertension. Home monitoring catches both of these patterns, which is why many providers now prefer it over office visits alone for diagnosing hypertension.
Lowering Blood Pressure Without Medication
If your readings are in the elevated or stage 1 range, lifestyle changes alone can often bring them back to normal. The most impactful single change is reducing sodium intake. A World Health Organization review found that cutting about 6 grams of salt per day (roughly one teaspoon) lowered systolic pressure by an average of 5.8 mm Hg across the population studied. In people who already had hypertension, the same reduction dropped systolic pressure by nearly 11 mm Hg. That’s a meaningful shift, enough to move some people from stage 1 hypertension back into the normal range.
Most dietary sodium comes from processed and restaurant food, not the salt shaker. Bread, deli meat, canned soups, frozen meals, cheese, and condiments are the biggest contributors for most people. Cooking more meals from whole ingredients tends to cut sodium intake significantly even without conscious effort.
Other changes with strong evidence include regular aerobic exercise (at least 150 minutes per week of moderate activity like brisk walking), maintaining a healthy weight, limiting alcohol to one drink per day or fewer, and eating a diet rich in fruits, vegetables, and whole grains. Each of these independently lowers blood pressure by a few points, and the effects stack. Combined, they can rival the impact of a first-line blood pressure medication.