Blood Pressure 140 over 90: What These Numbers Mean

You press the button on the blood pressure monitor, see 140 over 90, and want to know: is this already a diagnosis or not yet. I break it down by the numbers — where the boundary of normal lies, what each of the two numbers means, and when it's time to see a doctor.

Blood Pressure 140 over 90: Normal or Elevated

Arterial hypertension is systolic pressure of 140 mmHg or higher and/or diastolic pressure of 90 mmHg or higher. That is, 140 over 90 is not "almost normal" but the very threshold at which elevated pressure begins. When measured in a doctor's office, 140/90 and above is considered high; with home measurement, 135/85 and above. American guidelines are stricter: the first stage of hypertension starts at 130/80. A single reading decides nothing — the diagnosis is confirmed by several measurements at different times.

How to Read Systolic and Diastolic Pressure

The first number is systolic pressure: the force with which blood presses against the artery walls at the moment the heart contracts. The second is diastolic: the same pressure at the moment of relaxation. Normal is below 120/80 mmHg most of the time. Values of 120–129 with a lower number under 80 are called elevated pressure: here it is usually about lifestyle, not medication. Only one of the two numbers may be high — and one alone is already enough to speak of hypertension.

• The amount of water and salt in the body.
• The condition of the kidneys, nervous system, and blood vessels.
• Hormone levels, including the renin-angiotensin-aldosterone system.
• Age: blood vessels become stiffer and pressure rises.

What Nearby Values Mean: 130 over 90, 150 over 80, 120 over 90

130 over 90: the upper number is below the threshold, but the lower is exactly 90 — by definition that is enough. 120 over 90 — the upper number is ideal, the lower is at the boundary; formally this is also elevated pressure due to a single number. 140 over 80 and 150 over 80 — the upper number is at the threshold of 140 or above it with a normal lower number, so the pressure is considered elevated. 140 over 70 is read the same way as 140 over 80: the upper number decides. 150 over 90 — both numbers are above the thresholds of 140 and 90.

Why Diastolic Pressure Rises

The lower number shows the resistance blood meets in the vessels between heartbeats. If diastolic is 90 or higher, this also meets the definition of hypertension. With normal systolic pressure, the same mechanism of hypertension is at work — excess sodium and water, increased activity of the sympathetic nervous system, hormonal circuits such as the renin-angiotensin-aldosterone system.

Causes of 140 over 90 Blood Pressure and Accompanying Symptoms

In 90–95% of cases essential hypertension is found, when there is no specific external cause. The rest are secondary forms: renal 3–4%, endocrine 0.1–0.3%, plus the use of certain medications and supplements, pregnancy, and sleep-disordered breathing. The chances are higher if you are older, if relatives had hypertension, if your diet is high in salt, if you are overweight, smoke, drink alcohol, or have prolonged stress.

Myth: if your head doesn't hurt, your pressure is normal. Fact: hypertension most often proceeds without symptoms, and a person may not know about it for years — according to WHO estimates, of 1.13 billion people with hypertension, about 40% are unaware of the diagnosis. Rarely there may be headache, blurred vision, chest pain. With very high pressure, these are joined by severe headache, nausea and vomiting, confusion, vision changes, and nosebleeds.

When to See a Doctor and How the Diagnosis Is Confirmed

Everyone should check their blood pressure periodically, and after age 40 — once a year. The doctor measures several times, may ask for a home diary or a 24-hour monitor, and order tests: ECG, echocardiography, cholesterol test, blood chemistry, urinalysis, kidney ultrasound. This confirms the diagnosis, looks for secondary causes, and checks whether the heart, eyes, kidneys, and blood vessels have been affected.

140 over 90 by itself is not a reason to call an ambulance. Call 103 or 112 if pressing chest pain appears that does not go away and radiates to the arm, neck, jaw, abdomen, or back, especially with sweating, nausea, dizziness, and shortness of breath: these may be signs of a heart attack, and then immediate hospital care is needed.

This material is for reference: the numbers on the monitor do not make a diagnosis, and the decision about your blood pressure is made by a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer