Normal blood pressure is below 120/80 mmHg. That first number (systolic) measures pressure when your heart beats, and the second (diastolic) measures pressure between beats. The 2025 guidelines from the American Heart Association and American College of Cardiology confirm this threshold and break blood pressure into four categories that determine whether you need lifestyle changes, medication, or neither.
The Four Blood Pressure Categories
Every blood pressure reading falls into one of these ranges:
- 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
One important detail: if your two numbers fall into different categories, the higher category is the one that counts. So a reading of 135/75 is Stage 1 hypertension, even though the diastolic number looks fine on its own.
Elevated blood pressure is a warning zone. It means your numbers aren’t high enough to qualify as hypertension yet, but they’re trending in the wrong direction. Without changes, elevated blood pressure typically progresses to Stage 1 over time.
What Counts as Too Low
Blood pressure below 90/60 mmHg is generally considered low. But low blood pressure is only a problem if it causes symptoms. Some people naturally run lower numbers and feel perfectly fine. The symptoms to watch for include dizziness or lightheadedness, blurred vision, fatigue, trouble concentrating, and fainting. If low readings come with those symptoms, it’s worth investigating the cause, which can range from dehydration to medication side effects.
Severely low blood pressure can lead to shock, which looks different: cold and clammy skin, rapid shallow breathing, confusion (especially in older adults), and a weak, fast pulse. This is a medical emergency.
When Blood Pressure Becomes Dangerous
A reading of 180/120 mmHg or higher is a hypertensive crisis. There are two levels. In an urgent crisis, the numbers are that high but there’s no sign of organ damage. In an emergency crisis, those extreme pressures are actively damaging the heart, brain, kidneys, or other organs.
Red-flag symptoms at this level include severe headache, chest pain, shortness of breath, blurred vision or vision changes, seizures, and anxiety. If your reading hits 180/120 and you have chest pain, difficulty breathing, or signs of a stroke, call 911 immediately.
Targets for Older Adults
The standard categories apply at every age, but blood pressure management in older adults gets more nuanced. A common pattern after age 60 is isolated systolic hypertension, where the top number is 130 or higher but the bottom number stays below 80. This happens because arteries stiffen with age, forcing the heart to push harder during each beat while the resting pressure between beats stays relatively low.
A major NIH-funded trial called SPRINT found that lowering systolic blood pressure to below 120 in adults age 50 and older significantly reduced the risk of heart disease and death. That said, the ideal target for any individual depends on other health conditions, medications, and overall fitness. Aggressively lowering blood pressure in someone who is frail or prone to falls, for example, can cause more harm than good through dizziness and fainting.
Targets With Diabetes or Kidney Disease
If you have diabetes, chronic kidney disease, or both, guidelines push for tighter control. The general recommendation is below 130/80 mmHg, and some international guidelines aim even lower, targeting a systolic reading below 120. Research on adults with both diabetes and chronic kidney disease confirms that keeping systolic pressure under 130 and diastolic under 80 lowers the risk of cardiovascular events. Your doctor may adjust these targets based on how well your kidneys are functioning and what medications you’re taking.
Blood Pressure in Children
Children don’t use the same fixed numbers that adults do. A normal reading for a 5-year-old would look very different from a normal reading for a 15-year-old. Instead, pediatric blood pressure is evaluated using percentiles based on the child’s age, sex, and height. A reading at or above the 95th percentile for their demographic group is considered high. This means your child’s doctor compares their numbers against a reference population of kids the same age and size, rather than against a single universal cutoff.
How to Get an Accurate Reading
Blood pressure is surprisingly easy to measure wrong, and small mistakes can shift your numbers by 10 to 20 points. The CDC recommends a specific routine to get reliable readings at home.
Start by avoiding food, drinks, and caffeine for 30 minutes before measuring. Empty your bladder. Then sit in a comfortable chair with your back supported for at least five minutes before taking the reading. Both feet should be flat on the floor with legs uncrossed. Rest the arm wearing the cuff on a table at chest height, not hanging at your side. The cuff should sit against bare skin, snug but not tight. And don’t talk while the reading is in progress.
These details matter more than most people realize. Crossing your legs or letting your arm hang down can artificially raise your numbers. Talking during the measurement does the same. If you’ve ever gotten a high reading at the doctor’s office but normal numbers at home, rushing in from the parking lot and immediately getting cuffed (without that five-minute rest) is often the culprit.
For the most useful picture, take two or three readings one minute apart and average them. Doing this at the same time each day, over a week or two, gives you a much more reliable baseline than any single reading at a clinic visit.