Written by:Eli Ben-Yehuda, August 8, 2018

Blood pressure falls into five general categories, ranging from normal blood pressure to hypertensive crisis (This is very dangerous).

The level of your blood pressure will determine the course of treatment your physician may require. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings at three or more office visits.

When taking blood pressure reading, you should follow these simple rules:
  1. Make sure your feet are flat on the floor, and legs are uncrossed.
  2. Ensure your arm and back are properly supported.
  3. If you need to use the restroom go so you will feel comfortable
  4. Ensure your arm is bare, and the blood pressure cuff is on the skin, not over any clothing.
  5. Make sure you do not talk and that you have at least three minutes of quiet time prior to the measurement.

According to research, your blood pressure can elevate between 2-40mmHg by not following the simple guidelines for checking blood pressure. This can result in you being prescribed medication that you did not need. For example:

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When you have… Your BP Can Appear Higher By…
  • A full bladder, 10-15mmHg
  • An Unsupported Back, 5-10mmHG
  • Unsupported Feet, 5-10mmHg
  • Crossed Legs, 2-8mmHg
  • Cuff over clothing, 10-40mmHg
  • Unsupported arm, 10mmHg
  • Talking during reading, 10-15mmHg

Now can you see why it is so important? Please, when you visit your doctor ensure they follow these guidelines while you are getting your blood pressure checked. I have seen medical technicians checking a patients blood pressure when the patient was laughing.

What is a Normal Blood Pressure

An optimal normal blood pressure level is a reading under 120/80 mmHg.

120 represents the ‘top’ number, known as systolic blood pressure. Systolic: The blood pressure when the heart is contracting. It is specifically the maximum arterial pressure during contraction of the left ventricle of the heart. The time at which ventricular contraction occurs is called systole.

80 represents the bottom number, known as the diastolic blood pressure. Diastolic: Referring to the time when the heart is in a period of relaxation and dilatation (expansion). The diastolic pressure is specifically the minimum arterial pressure during relaxation and dilatation of the ventricles of the heart when the ventricles fill with blood.

For many years, readings over 120/80 mmHg and up to 139/89 mmHg were classified as ‘prehypertension,’ within the normal to high range. However, the American Heart Association and the American College of Cardiology have recently changed the blood pressure guidelines.

Now, anything between 120-129 systolic pressure with diastolic pressure under 80, is considered ‘Pre-hypertension.’ This is when your doctor will recommend you get proactive and make diet and lifestyle changes because, during this early time, you can greatly reduce your risk of cardiovascular problems.

Blood pressure over 130/80 mmHg is now considered to be high.

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A hypertensive crisis is blood pressure above 180/120 mmHg. If you experience blood pressure this high it is a medical emergency, so do not delay in visiting the hospital or calling 911.

Normal Blood Pressure Chart

The blood pressure chart used to look like this:

normal blood pressure chart

Under the new blood pressure guidelines, the blood pressure chart now looks like this:

new normal blood pressure chart

NOTE: Under these new guidelines, normal blood pressure has not changed, it is still below 120/80 mmHg. Only the higher ranges have changed to provide earlier intervention, with the goal of reducing the incidence of heart disease.

Is My Blood Pressure Really Elevated?

An elevated blood pressure is difficult to determine from one single reading. For instance, many people get what’s called ‘white coat hypertension.’ This is anxiety produced by the thought of visiting the doctor’s office.

Sudden or increased anxiety can temporarily increase blood pressure levels, which can give an inaccurate reading. Therefore, your physician may recommend you have regular blood pressure checks or use a home blood pressure monitor to record several readings.

How Do I Check My Blood Pressure At Home

To help ensure accurate blood pressure monitoring at home:

Check your device’s accuracy. Before using a monitor for the first time, have your doctor check its accuracy against the office model. Also, have your doctor watch you use the device to see if you’re doing it properly. If you drop the device or damage it, have it checked before using it again.

Measure your blood pressure twice daily. The first measurement should be in the morning before eating or taking any medications, and the second in the evening. Each time you measure, take two or three readings to make sure your results are accurate. Your doctor might recommend taking your blood pressure at the same times each day.

Don’t measure your blood pressure right after you wake up. You can prepare for the day, but don’t eat breakfast or take medications before measuring your blood pressure. If you exercise after waking, take your blood pressure before exercising.

Avoid food, caffeine, tobacco, and alcohol for 30 minutes before taking a measurement. Also, go to the toilet first. A full bladder can increase blood pressure slightly.

Sit quietly before and during monitoring. When you’re ready to take your blood pressure, sit for five minutes in a comfortable position with your legs and ankles uncrossed and your back supported against a chair. Try to be calm and not think about stressful things. Don’t talk while taking your blood pressure.

Make sure your arm is positioned properly. Always use the same arm when taking your blood pressure. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You might need to place a pillow or cushion under your arm to elevate it high enough.

Place the cuff on bare skin, not over clothing. Rolling up a sleeve until it tightens around your arm can result in an inaccurate reading, so you may need to slip your arm out of the sleeve.

Take a repeat reading. Wait for one to three minutes after the first reading, and then take another to check accuracy. If your monitor doesn’t automatically log blood pressure readings or heart rates, write them down.

Blood pressure varies throughout the day, and readings are often a little higher in the morning. Also, your blood pressure might be slightly lower at home than in a medical office, typically by about five points.

Contact your doctor if you have any unusual or persistent increases in your blood pressure. Ask your doctor what reading should prompt an immediate call to the medical office.

High Blood Pressure According To Age:

Average readings tend to be lower at a younger age and increase with age. During late adolescence years (around 17-19 yrs old) doctor typically begins to follow the standard adult guidelines for high blood pressure.

As we age, our bodies become more susceptible and at higher risk of developing high blood pressure.

In normal blood pressure for elderly & adults over 50, increased systolic blood pressure is a major risk factor for heart disease. Systolic blood pressure tends to increase steadily over time due to stiff arteries, a build-up of plaque, and a higher rate of cardiac and vascular disease. This means older adults need to be even more vigilant about monitoring their blood pressure.

According to the National Institute on Aging, males are more likely to have high blood pressure before age 55, while normal blood pressure for women tends to see a rise in after menopause. Women are less likely than men to experience complications associated with high blood pressure.

However, regardless of differences in the prevalence and complications of high blood pressure between the sexes, treatment and diagnosis are the same for both men and women.

Normal Blood Pressure According To Gender

Refer to the below chart for Prevalence of hypertension among adults aged 18 and over, by sex and age

normal blood pressure prevalence chart by age and gender

Source: NCHS Data Brief No. 289, October 2017

Men are at greater risk for cardiovascular and renal disease than are age-matched, premenopausal women. Recent studies using the technique of 24-hour ambulatory blood pressure monitoring have shown that blood pressure is higher in men than in women at similar ages

After menopause, however, blood pressure increases in women to levels even higher than in men. Hormone replacement therapy in most cases does not significantly reduce blood pressure in postmenopausal women, suggesting that the loss of estrogens may not be the only component involved in the higher blood pressure in women after menopause. In contrast, androgens may decrease only slightly, if at all, in postmenopausal women.

Why is Normal Blood Pressure so Important?

Maintaining normal blood pressure is essential for heart health. When your blood pressure is high, your heart and arteries can become overloaded.

High blood pressure can accelerate the buildup of plaque on the artery walls (atherosclerosis), clogging blood flow to your heart muscle, putting you at risk of heart attack. It also weakens the walls of arteries in your brain which can cause a stroke.

It can affect arteries to other parts of your body too, such as the eyes, kidneys, and legs. Long-term high blood pressure is known as hypertension and is one of the main risk factors for heart disease.

Blood pressure goes up and down throughout the day. It depends on the time of day, the amount of fluid in your body, the medicines in your system and what you are doing. Your blood pressure can also be affected by things like your breathing, your emotions, exercise, and sleep.

These temporary rises are completely natural and your blood pressure will generally return to normal when you rest.

Causes for High Blood Pressure

The exact cause of high blood pressure is often not clear. However, various lifestyle conditions and behaviors have been known to significantly contribute to high blood pressure:

  • Being overweight
  • Not getting enough physical activity
  • Drinking more than 2 alcoholic drinks per day
  • Stress
  • Old age
  • Smoking
  • A family history of high blood pressure
Hypertension and Its Risks

Prolonged high blood pressure is known as hypertension. Left undiagnosed, and untreated, hypertension can lead to several health conditions:

  • Atherosclerosis
  • Coronary heart disease (CHD)
  • Ischemic heart disease (IHD)
  • Heart attack
  • Kidney disease
  • Stroke


How Can You Get Your Blood Pressure Back to Normal?

Healthy lifestyle changes help to bring blood pressure levels down. And amazingly, there are many things you can do to achieve healthy blood pressure once again.

Follow a healthy diet

The Dietary Approaches to Stop Hypertension or ‘DASH’ diet is an eating plan known to produce great results with blood pressure. In fact, studies show the DASH diet can lower blood pressure by an average 6.74 mmHg systolic blood pressure and 3.54 mmHg diastolic blood pressure.

The DASH diet is a plant-focused diet rich in fruits and vegetables, nuts, with low-fat and non-fat dairy, lean meats, fish, and poultry, mostly whole grains, and heart-healthy fats such as olive oil, avocado, nuts, and seeds.

Essentially any changes you can make to your diet will help. Try cutting down on processed and packaged food and choose fresh, natural ingredients.

Get Exercising more

Exercise alters the structure of arteries, decreases arterial stiffness, and regulates one of the most important blood pressure control centers in your body — the autonomic nervous system.

One reason exercise is so effective at controlling blood pressure is because it stimulates your body to release a substance called nitric acid. Nitric acid causes blood vessels to open up, which reduces blood pressure. Exercise also helps to strengthen your heart muscle, reduce stress, and aid weight loss.

Aerobic exercise has been shown to reduce blood pressure by an average 5-7 mmHg. Strength training reduces it an average 2-3 mmHg.

All you need is an average of 30 minutes of exercise most days of the week. If you’re not getting that now, think about how you can include it.

For a healthy body, including both aerobic exercise and strength training is a good idea.

Aerobic exercise includes walking, cycling, and swimming. Strength training includes bodyweight exercises like squats and lunges, weight training or resistance training with machines or therabands.

Blood Pressure During Exercise

How much your blood pressure increases with exercise depends on your usual resting blood pressure levels, and your work rate, or the type, intensity, and duration of physical activity. During exercise, your heart rate — and systolic pressure — go up, because cardiac output increases to pump more blood and oxygen to working muscles.

In people without hypertension, most types of exercise can push systolic blood pressure to the 160 to 200 mm Hg range, and intense exercise such as weight lifting can temporarily push systolic pressure to even higher levels.

Exercise also causes vasodilation, or the widening of blood vessels, which increases blood flow and decreases peripheral resistance — which, in healthy people, keeps the diastolic blood pressure from rising during activity. In fact, a diastolic blood pressure increasing greater than 10 mmHg during or after exercise represents an unstable form of hypertension, and may be associated with coronary artery disease, notes Len Kravitz, Ph.D. of the University of New Mexico.

Blood Pressure After Exercise

Right after exercise is stopped, blood pressure decreases — often to levels a bit lower than normal resting blood pressure, and this effect can last for hours. Also, people who exercise regularly usually experience permanent improvements in resting blood pressure levels, as exercise strengthens the heart, helps with weight loss, improves circulation and lessens peripheral resistance — all factors that benefit blood pressure.

Take blood pressure medications as prescribed

Since it is so important to lower blood pressure levels within the normal range, blood pressure medications may also be necessary. There are many different medications available so if your doctor prescribes you something and you have terrible side effects, please talk to them about alternative options.

Breathing Exercises

Researchers at the University of Melbourne and Macquarie University have uncovered unusual activity between neurons controlling breathing and blood pressure during the development of essential hypertension. Essential hypertension, which is high blood pressure with no known cause, affects 30% of the global population and is a major contributor to cardiovascular disease.

Researchers have documented the benefits of a regular practice of simple, deep breathing which include:

  • Reduced anxiety and depression
  • Lower/stabilized blood pressure
  • Increased energy levels
  • Muscle relaxation
  • Decreased feelings of stress and overwhelm

Our FDA-cleared RESPeRATE device uses guided breathing technology to help patients perform daily paced breathing exercises easily and at their convenience, as demonstrated in multiple studies.

RESPeRATE has been proven to be effective for lowering blood pressure in several clinical trials.

Further Reading on Normal Blood Pressure and related issues:

From high blood pressure to normal blood pressure click here  

Click Here For further information concerning normal blood pressure.

Dr. Cynthia Thaik

Reviewed by Dr. Cynthia Thaik, M.D.

Dr. Cynthia is a Harvard-trained Los Angeles cardiologist.

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