"Is a blood pressure of 130/70 anything to worry about?"
It's a good question, and one doctors didn't regularly field until the Joint National Committee of the American Heart Association announced its hypertension criteria in 2017. It was the first criteria upgrade since 2003. Though it's been around a while, it still causes some confusion, as not everyone is up to speed on the latest guidelines.
For years, the upper limit of normal blood pressure (BP) for all adults was 140 systolic pressure (SBP) over 90 diastolic pressure (DBP) mmHg. Higher numbers usually required treatment . With 130/70, you’d have been the envy of every hypertensive ! Sorry, but that has changed.
Although it is still true that no healthy adult man or woman should have a blood pressure greater than 140/90, there are now additional guidelines to identify those at high risk for developing hypertension and cardiovascular complications.
TL;DR: Nowadays, 130/70 is, in fact, considered a cause for concern but not an emergent situation.
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"A reading of 130/70 mmHg falls under the category of stage 1 hypertension according to guidelines from the American College of Cardiology and the American Heart Association," explains Dr. Rigved Tadwalkar, MD , a board-certified consultative cardiologist at Providence Saint John’s Health Center. "So, yes, it is a cause for attention. Although not an emergency, it is definitely a wake-up call to address your cardiovascular health."
If you have hypertension, you're not alone. The American Heart Association reports that about half of U.S. adults have high blood pressure. Understanding what constitutes as high blood pressure, what those numbers mean anyway and how to treat and prevent hypertension are all ways to take the reigns of your health. Cardiologists discussed blood pressure numbers and ways to manage yours.
What Is Normal Blood Pressure?
According to the American Heart Association , a "normal" blood pressure is less than 120/80.
This chart can help you determine your numbers, based on the American Heart Association's criteria.
Credit: American Heart Association
Blood Pressure Reading
| Blood Pressure Category | Systolic mm Hg (upper number) and/or | Diastolic mm Hg (lower number) |
|---|
Normal | Less than 120 and | Less than 80 |
Elevated | 120-129 and | Less than 80 |
Stage 1 Hypertension | 130-139 or | 80-89 |
Stage 2 Hypertension | 140 or higher or | 90 or higher |
Hypertensive crisis (immediate attention needed) | Higher than 180 and/or | Higher than 120 |
It's a lot of numbers (OK, two). Still, what do they really measure, anyway?
"When you check your blood pressure, it gives two numbers over a fraction," explains Dr. Wahaj Aman, MD , a cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann. "The top number, known as systolic pressure (SBP) is the pressure in your arteries when your heart contracts. The number represents the effort your heart is using to course blood through your circulatory system."
As for diastolic?
"Diastolic blood pressure is the 'bottom number' when you measure your blood pressure and this represents the resting tone of your arteries or the pressure when your heart is in between beats and in the relaxed state, filling up with blood," says Dr. Mary Greene, MD , a cardiologist with Manhattan Cardiology in NYC and contributor to labfinder.com.
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What Does It Mean To Be Pre-Hypertensive?
You'll notice pre-hypertensive is not listed as a category in the above chart taken from the AHA guidelines. There's a reason for that: "Prehypertension is no longer a formal category based on recent definitions," Dr. Tadwalkar says. "Previously, it referred to blood pressure readings that were higher than normal but not yet high enough to be classified as stage 1 hypertension."
Dr. Tadwalkar says people were told they were "pre-hypertensive" if their systolic blood pressure values were in the 120-129 range but their diastolic numbers remained under 80 mmHg.
"This category is now called "elevated" blood pressure," Dr. Tadwalkar says. "In any case, these readings do indicate an increased risk of developing hypertension in the future."
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What Blood Pressure Stages Require Drug Treatment?
The answer to this question varies. Generally: "Medications are typically started when blood pressure is over 140/90mmHg," Dr. Aman says. In other words, hypertension stage 2 or crisis, the latter of which actually requires immediate medical assistance.
For stage 1 hypertension, the American College of Cardiology recommends medication for patients who have "already had a cardiovascular event such as a heart attack or stroke," or for those at "high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol)."
For most people with elevated or stage 1 hypertension, lifestyle interventions are typically recommended first, Dr. Greene says. These can include:
- Diet, such as the Dietary Approaches to Stop Hypertension (DASH diet) , an eating plan of low-sodium foods, fruits, vegetables, and low-fat dairy products
- Exercising
- Limiting alcohol consumption
- Stress management
- Weight management
- Getting 7 to 8 hours of sleep each night
"Remember that even small changes in your lifestyle can significantly impact your blood pressure and your overall cardiovascular health," Dr. Tadwalkar says. "Think of it as an investment for the future. If you have any concerns about your blood pressure, consult your doctor to discuss the best course of action for you."
Whether you're taking medication or using lifestyle approaches, it's crucial to attend follow-up appointments and take your blood pressure at home as directed by your healthcare team.
"It is imperative to monitor blood pressure regularly to treat it effectively," Dr. Aman says.
So, back to the original question, 130/70 is OK in an otherwise healthy person in the sense that you don’t need ASAP medical intervention. It may be managed using lifestyle tweaks. Still, it should be checked on a regular basis. Also, keep in mind that the recommendations from the American Heart Association state that BP should not be higher than 120/80 for those at risk for coronary artery disease or who already have it (angina, history of a heart attack). Speak with your doctor about the best course for your specific situation.
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