Stage 2 Hypertension: What the Blood Pressure Numbers Mean

In a doctor's report, designations of stage or grade may appear next to the diagnosis. We explain what the blood pressure numbers mean and how they differ from the assessment of organ damage.

What hypertension is and how it is divided into stages

Blood pressure is the force with which blood presses against the walls of the arteries. At the moment the heart contracts, it is at its maximum (systolic); between beats it falls (diastolic); a reading of 120/80 means systolic 120 and diastolic 80. Hypertension is a persistent elevation of blood pressure: systolic from 140 mm Hg and above and, simultaneously or on its own, diastolic from 90 mm Hg and above. In 90–95% of cases this is essential hypertension, that is, hypertensive disease; the rest are secondary forms against the background of other diseases.

The blood pressure numbers show only the blood pressure level but do not indicate the condition of the organs.

The doctor assesses the blood pressure level, risk factors, organ damage and concomitant conditions — based on these data, WHO and the International Society of Hypertension assign patients to absolute risk groups.

Stage 2 hypertension: what the blood pressure numbers are

In the American classification used (MedlinePlus), Stage 1 (systolic 130–139 or diastolic 80–89) and Stage 2 (systolic 140 and above or diastolic 90 and above) are distinguished. In a Russian report, the word "stage" and its number are determined by the doctor, and they cannot be matched to these categories without the report. Here is the full scale:

• normal blood pressure — below 120/80;
• elevated — systolic 120–129 with diastolic below 80;
• Stage 1 — systolic 130–139 or diastolic 80–89;
• Stage 2 — systolic 140 and above or diastolic 90 and above;
• hypertensive crisis — blood pressure above 180 and above 120, medical help is needed immediately.

When measured in a medical facility, the threshold for hypertension is 140/90 and above; when measured at home, 135/85 and above. The diagnosis is not made from a single measurement: two or more measurements at different visits are needed.

Risks and complications of high blood pressure

Constantly high blood pressure overloads the blood vessels, heart, brain, kidneys and eyes. Without treatment, it increases the risk of heart disease, heart attack, stroke, heart failure, kidney disease and vascular dementia. Lowering blood pressure even by a small amount reduces these risks. Hypertension itself usually causes no symptoms, so the only way to find out about it is to measure blood pressure regularly.

How it is diagnosed and when a doctor is needed

Diagnosis begins with measuring blood pressure in the doctor's office or at a pharmacy. If the readings are elevated, home monitoring over several days, a repeat visit or 24-hour wearing of a portable monitor is suggested. The doctor assesses blood pressure, risk factors and concomitant conditions and, if necessary, orders tests. Blood pressure should be checked if you are over 40 years old and have not measured it for more than five years, as well as with headaches, blurred vision or periodic chest pain.

Elevated blood pressure by itself is not a reason to call an ambulance. Call 103 or 112 if sudden pressing chest pain appears that does not go away, pain radiates to the arm, neck, jaw, abdomen or back, as well as with sweating, nausea, dizziness or shortness of breath — this may be a heart attack.

This material is for reference: it explains terms but does not replace a doctor's consultation, which will assess your specific situation.

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