Hypertension Stages 1–3: Understanding the Stages (2024)

About half of all American adults have some level of hypertension (high blood pressure), but not all high blood pressure is created equal. Blood pressure readings typically fall into four categories, but there are only two official hypertension stages.

This article explores the categories and stages of high blood pressure, what category your blood pressure measurement puts you in, and when you need to act.

Hypertension Stages 1–3: Understanding the Stages (1)

Blood Pressure CategoryBlood Pressure Reading
Normal120/80 and below
Elevated120–129/80
Stage 1 hypertension130–139/80–89
Stage 2 hypertension140/90 and higher
Hypertensive crisis180/120 and higher

Elevated Blood Pressure

Your blood pressure is considered elevated when your systolic blood pressure (the top number of your blood pressure reading) is above 120 millimeters of mercury (mm Hg) and your diastolic blood pressure (the bottom number of your blood pressure reading) is above 80 mm Hg.

People with elevated blood pressure usually don't experience symptoms. Instead, their elevated blood pressure is identified during routine blood pressure measurements, such as at an annual well visit. A healthcare provider will confirm your elevated blood pressure if it measures above the normal range with two more readings on at least two separate occasions.

At this stage, you are at an increased risk of developing more severe hypertension, and a healthcare provider may suggest various lifestyle and dietary changes. Healthcare providers don't usually prescribe medications to treat elevated blood pressure.

Hypertension Stages 1–3: Understanding the Stages (2)

Checking Your Blood Pressure

Your blood pressure is measured with a cuff that goes around your arm. The cuff inflates, and your healthcare provider will listen for the sound of the pulse to determine the pressure in your blood vessels. You can also use automatic devices to measure your blood pressure at home.

Stage 1 Hypertension

Stage 1 hypertension is classified as a systolic blood pressure reading that falls between 130 and 139 mm Hg or a diastolic reading that is between 80 and 89 mm Hg.

As with elevated blood pressure, you are unlikely to experience symptoms of high blood pressure at this stage.

A healthcare provider may recommend changes to your diet and lifestyle or prescribe medication to lower blood pressure. In stage 1, medications are usually recommended for people who are experiencing symptoms of high blood pressure, who have tried diet and lifestyle changes without success, or who have other medical problems that may make high blood pressure more dangerous.

Stage 2 Hypertension

When your systolic blood pressure measures 140 mm Hg or higher, or your diastolic pressure is 90 mm Hg or higher, a healthcare provider will diagnose you with stage 2 hypertension.

You can have stage 2 hypertension and still be asymptomatic. In many cases, high blood pressure is only diagnosed by measuring your blood pressure and not by symptoms you would notice.

Stage 2 hypertension is treated with a combination of lifestyle changes, diet modifications, and medications. While earlier stages of hypertension—or hypertension in people without other risk factors, might be treated with dietary and lifestyle changes alone—prescription medications are indicated when your blood pressure is consistently measuring 140/90 mm Hg and higher.

Many medications are used to treat high blood pressure, and you may be prescribed one or a combination of drugs.

Hypertensive Crisis

A hypertensive crisis is the category of hypertension where you are most likely to experience symptoms. You are diagnosed with a hypertensive crisis if your blood pressure measurement exceeds 180/120 mm Hg.

At this level, your high blood pressure may cause symptoms like:

  • Headache
  • Chest pain
  • Shortness of breath
  • Fatigue or weakness
  • Vision changes
  • Speech problems

You may already be taking medications to control your blood pressure, but blood pressure measurements at this level require additional treatment. Call a healthcare provider or seek immediate medical treatment if your blood pressure is 180/120 mm Hg or higher.

You may require treatment with medications only given in a hospital, or your healthcare provider may adjust the doses and types of your regular medications. Without action to control a hypertensive crisis, you have a higher risk of having a heart attack or stroke.

How Hypertension Gets Worse

Getting control of your blood pressure is necessary to avoid complications like heart attack and stroke. Not managing your blood pressure in the early stages can cause your blood pressure to run even higher, putting you at risk of a range of medical issues.

Talk to your healthcare provider about regular screenings, checkups, and medications to manage your hypertension.

Can You Lower Your Hypertension Stage?

With a consistently healthy dietary and lifestyle and adherence to the treatment plan you develop with your healthcare provider, you can control your blood pressure and possibly prevent more severe hypertension from developing.

Hypertension treatment and lifestyle changes can help lower your high blood pressure. For example, studies have shown that weight loss directly impacts blood pressure measurements, so watching your diet, exercising, and losing weight could help some people reduce their blood pressure by several points.

How to Lower Hypertension Risks and Complications

Uncontrolled high blood pressure is a significant risk factor for various medical emergencies and advanced diseases. Controlling your blood pressure with a combination of lifestyle changes and medications is the most effective way to manage your hypertension and reduce the risk of serious complications.

High Blood Pressure Risk Factors

You can't control every risk factor for high blood pressure, such as your age, race, sex, and genetics. However, changing certain lifestyle habits can help to improve your blood pressure.

Quitting smoking, eating a nutrient-dense diet, and exercising regularly can help to reduce your risk of developing high blood pressure and its associated complications.

Summary

Hypertension falls into different levels and stages based on your blood pressure measurement. Lifestyle and diet changes and the use of prescription medications can help you prevent your blood pressure from going higher and experiencing more severe complications.

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Centers for Disease Control and Prevention. Facts about hypertension.

  2. American Heart Association. Understanding blood pressure readings.

  3. Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends. Cardiovasc. Med. April 2020;30:3(160-164). doi:10.1016/j.tcm.2019.05.003.

  4. Centers for Disease Control and Prevention. High blood pressure symptoms and causes.

  5. Centers for Disease Control and Prevention. Measuring your blood pressure.

  6. American Heart Association. The facts about high blood pressure.

  7. American Heart Association. Hypertensive crisis: when you should call 911 for high blood pressure.

  8. Cohen JB. Hypertension in obesity and the impact of weight loss. Curr Cardiol Rep. August 2017;19(10):98. doi:10.1007/s11886-017-0912-4.

  9. Unger T, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. May 2020;75:1334-1357. doi:10.1161/HYPERTENSIONAHA.120.15026.

  10. World Health Organization. Hypertension.

Hypertension Stages 1–3: Understanding the Stages (3)

By Rachael Zimlich, BSN, RN
Zimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years.

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