© Megaflopp | Dreamstime.com
High blood pressure – hypertension – used to be when your blood pressure was consistently 140 over 90 or higher. In 2017, the American Heart Association (AHA) lowered the number to 130 over 80 and changed the blood pressure chart categories. 
The only way to know if you have hypertension, is to know your blood pressure numbers and where they fit in on the blood pressure chart. Knowing your numbers is the key to controlling your blood pressure.  This is really important because on the new chart, almost half of American adults fall into one of the high blood pressure categories. 
What Is Blood Pressure?
Your blood pressure is a measurement of the pressure inside your arteries, the blood vessels that carry blood away from your heart. High pressure on the walls of your arteries causes damage to the arteries and to other organs of your body. This damage usually occurs without any warning symptoms of hypertension. 
Blood pressure is measured in millimeters of mercury (mm Hg). There are two numbers measured during a blood pressure check, and they are both important: 
- Systolic blood pressure is the pressure inside arteries when your heart beats, forcing more blood through your arteries.
- Diastolic blood pressure is the pressure inside arteries between heartbeats when your heart is relaxed.
- The risk of death from heart disease or stroke doubles for each 20 mm Hg elevation of systolic blood pressure and each 10 mm Hg of diastolic blood pressure in adults ages 40 to 89.
The New Chart and Blood Pressure Categories
AHA now recognizes five blood pressure ranges and categories: 
- If you are in the normal category, you do not need any treatment but you should stick to a heart-healthy diet and regular exercise routine.
- If you are in the elevated category, you are likely to develop higher blood pressure and you should start making lifestyle changes to prevent higher blood pressure now.
- Stage 1 hypertension always requires lifestyle changes and may require medication if you have other risk factors for heart attack or stroke.
- Stage 2 hypertension usually requires both lifestyle changes and medication.
- Hypertensive crisis always requires a call to your doctor and may require a 911 call if you have chest or back pain, difficulty breathing, numbness, weakness, or difficulty speaking.
To diagnose one of these categories, your blood pressure should consistently fall in the range on the chart. Your doctor will take your blood pressure several times at three or more office visits and may have you take your own pressure at home. All these readings will be factored into a diagnosis of hypertension.  Here is the new chart: 
- Normal Blood Pressure: Systolic less than 120 and diastolic less than 80
- Elevated Blood Pressure: Systolic 120 to 129 and diastolic less than 80
- Stage 1 Hypertension: Systolic 130 to 139 or diastolic 80 to 89
- Stage 2 Hypertension: Systolic 140 or higher or diastolic 90 or higher
- Hypertensive Crisis: Systolic higher than 180 and/or diastolic higher than 120
Lifestyle Changes for Hypertension
Some people may need medications to control their blood pressure. There are many options depending on your overall health, blood pressure, and response to medication. Some people will need to take more than one type of medication. 
In many cases, lifestyle changes may be the only treatment you need. These lifestyle changes are important for everyone with hypertension: 
- A heart-healthy diet
- Limiting salt
- Maintaining a healthy weight
- Increasing physical activity
- Limiting alcohol
- Not smoking
- Managing stress
Blood Pressure Diet?
Help yourself and your blood pressure level by considering your diet. These University Health News posts will help lead you toward heart-healthy foods:
- “Foods That Lower Blood Pressure: Dig Into the DASH Diet“
- “7 Foods That Lower Blood Pressure“
- “Spice Up Your Life With These High Blood Pressure Remedies“
- “3 Benefits Paleo Diet Followers Enjoy in Just 10 Days“
- “High Blood Pressure Remedies in the Dairy Aisle?“
- Harvard Health Publishing, The new blood pressure guidelines: Massages you may have missed, https://www.health.harvard.edu/heart-health/reading-the-new-blood-pressure-guidelines
- American Heart Association, Understanding Blood Pressure Readings, https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings
- Mayo Clinic, High blood pressure (hypertension), https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410