Blood Pressure Chart: The 2025 Categories Explained

Under the 2025 AHA/ACC guideline, normal blood pressure is below 120/80, elevated is 120 to 129 systolic with a diastolic under 80, Stage 1 hypertension is 130 to 139 or 80 to 89, and Stage 2 is 140 or higher or 90 or higher. Those cutoffs are the same ones the 2017 guideline used, so if you learned the chart a few years ago, the numbers still hold. For what each stage means in practice, see stage 1 vs stage 2 hypertension.

What did change sits around the edges: the name for very high readings, the risk calculator doctors use, and how long lifestyle changes get before medication comes up.

The 2025 blood pressure chart

The top number (systolic) is the pressure in your arteries while your heart beats. The bottom number (diastolic) is the pressure between beats. Both are in millimeters of mercury (mm Hg).

The thresholds for the first four rows come straight from the guideline summary. The "typical next step" column is the general shape of the guideline's advice, and your own doctor will tailor it to you.

The "or" rule: the worse number decides

Look at the little words in the diastolic column. Normal and Elevated need both numbers to qualify ("and"). The hypertension stages need only one ("or").

So 118/84 is Stage 1, even though the top number is normal, because 84 is in the Stage 1 diastolic range. And 142/76 is Stage 2, because 142 is enough on its own. Whichever number lands in the higher category sets your category.

This one trips people up. A great top number doesn't cancel out a high bottom number, and the reverse is true too.

What changed in 2025 versus 2017

The categories didn't move. A 2025 review in Hypertension by McCarthy and colleagues states that the four categories and the 130/80 threshold for diagnosing hypertension are the same as in 2017. The overall treatment goal for adults is still under 130/80. There's a fuller rundown in the 2025 blood pressure guideline, explained.

Here's what's new:

• "Hypertensive urgency" is now "severe hypertension." It means a reading higher than 180/120 without signs of acute organ damage. You'll still see "hypertensive crisis" on older charts, including some government pages.
• A new risk calculator. Doctors now estimate 10-year cardiovascular risk with the AHA's PREVENT equations instead of the older pooled cohort equations. PREVENT adds kidney function and statin use, and it drops race. A PREVENT risk of 7.5% or more is the new line for "higher risk" (the old calculator used 10%).
• A clock on lifestyle-only treatment. For lower-risk adults whose blood pressure stays at 130/80 or above, the guideline now recommends medication if 3 to 6 months of lifestyle changes haven't brought it below 130/80.
• A brain health target. The guideline added a recommendation to aim for a systolic under 130 to help lower the risk of cognitive impairment and dementia.

Why one reading doesn't put you in a category

Your category comes from an average, not from a single number. Blood pressure moves with stress, caffeine, a full bladder, a brisk walk to the car, and a dozen other things, so one reading tells you about that moment.

The guideline recommends confirming a hypertension diagnosis with readings taken outside the office, either at home or with a 24-hour monitor. For home readings, the protocol from Target:BP (an AHA and AMA program) is:

1. Two readings, one minute apart, each time you measure.
2. Measure in the morning and in the evening.
3. Do this for seven days in a row.
4. Average all of it, top numbers and bottom numbers separately.

If you're new to home readings, our guide on how to measure blood pressure at home covers posture, cuff size, and the small mistakes that add points.

One wrinkle for the top of the chart. Home averages run a little differently from office readings, and Target:BP treats a home average of 135/85 or higher as Stage 2 (versus 140/90 in the office). Your doctor will know how to read your home numbers, so bring the whole log rather than just the highlights. Our guide on sharing home readings with your doctor covers what's most useful to bring.

When to call your doctor, and when to call 911

Call 911 if your reading is higher than 180/120 and you have any of these: chest pain, shortness of breath, severe headache, dizziness, confusion, heart palpitations, vision changes (eye pain, sudden blurriness, or loss of vision), or stroke signs like a drooping face, slurred speech, or sudden weakness. Cleveland Clinic lists these as warning signs of a hypertensive emergency. Don't wait to recheck if you have symptoms.

If your reading is higher than 180/120 and you feel fine, rest for a few minutes and measure again. If it hasn't come down, seek medical care promptly. Under the 2025 guideline, severe hypertension without organ damage is usually managed in outpatient care rather than the hospital, but it still shouldn't wait for your next routine visit.

Call your doctor soon (not urgently) if your home averages are in Stage 1 or Stage 2 territory over a week or more, if your numbers are climbing over a few weeks, or if you're already on treatment and your averages stay above the goal your doctor set.

Elevated readings are worth a mention at your next regular visit. Our guide to elevated blood pressure (120 to 129) goes deeper on what that range means.

Low blood pressure

The chart above stops at "normal," but blood pressure can also run too low. The National Heart, Lung, and Blood Institute defines low blood pressure (hypotension) as lower than 90/60.

A low number on its own isn't always a problem, and some people run low all the time. How you feel matters a lot here. Symptoms NHLBI lists include:

• Dizziness or lightheadedness
• Fainting
• Confusion
• Blurry vision
• Feeling tired or weak
• Nausea

If you have symptoms like these, or your numbers have dropped compared with what's normal for you, talk to your doctor.

Call 911 for signs of shock: cold or sweaty skin, rapid breathing, a bluish skin tone, or a weak pulse.

Some people only get lightheaded when they stand up. That pattern, a drop in pressure on standing, is called orthostatic hypotension, and you can check for it at home. See our guide to the orthostatic hypotension test at home.

Common questions

Is 130/80 high blood pressure now?

Yes, and it has been since 2017. A systolic of 130 or a diastolic of 80, as your average, puts you in Stage 1 hypertension. The 2025 guideline kept that threshold.

My top number is normal but my bottom number is 82. What category is that?

Stage 1. Because the hypertension stages use "or," a diastolic of 80 to 89 is enough on its own, whatever the top number is.

What happened to "hypertensive crisis"?

The 2025 guideline uses "severe hypertension" for readings higher than 180/120 without organ damage (this used to be called hypertensive urgency) and "hypertensive emergency" when there are signs of organ damage. "Hypertensive crisis" was the umbrella term on older charts, and you'll still run into it.

Do these categories apply to everyone?

The guideline is written for adults who aren't pregnant, and the same cutoffs apply at every adult age (see blood pressure chart by age for what's typical). Children and teens are assessed differently, and blood pressure in pregnancy has its own recommendations, so ask your pediatrician or obstetric team in those cases.

How BP Log fits in

BP Log runs the two-reading flow for you, with readings a minute apart, timed and averaged automatically, and classifies every reading against the current guideline categories. It also shows your morning and evening averages separately and can print a doctor visit report with a summary and every reading split AM and PM.