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When your doctor says your blood pressure is 140 over 90, what does that actually mean? If you’re newly diagnosed with hypertension—or helping a loved one manage it—understanding how to read and interpret these numbers is one of the first steps to gaining control over the condition.
What Is Blood Pressure?
Blood pressure is the pressure, measured in millimeters of mercury, within the major arterial system of the body. It is conventionally separated into systolic and diastolic determinations. These two figures represent different phases of your heartbeat, and each tells a different story about your cardiovascular health. Systolic pressure is the maximum blood pressure during contraction of the heart; diastolic pressure is the minimum pressure recorded just prior to the next contraction.
Systolic Pressure: The Top Number
The systolic number is the higher of the two and comes first in a reading. It measures the pressure in your arteries when your heart beats and pumps blood out. Think of it as the maximum pressure your heart exerts during activity.
- A normal systolic reading is generally less than 120 mmHg
- Readings of 130 mmHg or higher are considered elevated or high, depending on the range
High systolic pressure is often more closely linked to complications such as stroke and heart attack, especially in older adults.
Diastolic Pressure: The Bottom Number
The diastolic number is the lower figure and follows the systolic. It measures the pressure in your arteries when your heart is at rest between beats.
- A normal diastolic reading is 80 mmHg
- A reading of 90 mmHg or more typically indicates high blood pressure
While systolic pressure tends to get more attention, elevated diastolic pressure—especially in younger people—can be an early sign of long-term risk.
Why Both Numbers Matter
Both numbers are important. You can’t ignore one just because the other seems normal. For example:
- Isolated Systolic Hypertension (high top number, normal bottom)
Isolated systolic hypertension can be caused by conditions such as:
- Artery stiffness.
- An overactive thyroid, also called hyperthyroidism.
- Diabetes.
- Heart valve disease.
- Obesity.
Over time, having a top blood pressure number that is high can raise the risk of stroke, heart disease, dementia and chronic kidney disease.
- Isolated Diastolic Hypertension (normal top number, high bottom) This is common in:
- metabolic syndrome
- chronic kidney disease
- thyroid issues
- sleep apnea
In both cases, the risks of heart disease, stroke, and kidney problems increase over time if not properly managed.
What’s Considered Normal, Elevated, or High?
The American Heart Association categorizes hypertension readings into the following
If your readings consistently fall into the elevated or high categories, it’s time to take action.
How to Monitor Your Blood Pressure Correctly
- Use a validated monitor—ideally an upper arm cuff, not a wrist device.
- Sit calmly for five minutes before taking a reading.
- Take multiple readings and average them for a more accurate picture.
- Track your results over time to spot patterns.
Apps and platforms like Blueberry help patients log their readings, get alerts when something’s off, and stay connected with their care team. Consistent tracking is one of the most effective ways to avoid complications.
When to See a Doctor
If you consistently see readings above 130/80, especially with symptoms like headaches, dizziness, or chest pain, don’t wait. Seek medical advice. High blood pressure is often called the “silent killer” because it rarely shows symptoms early on.
The Bottom Line
Blood pressure isn’t just a pair of numbers—it’s a snapshot of how hard your heart is working and how well your blood vessels are handling the load. Understanding the difference between systolic and diastolic pressure can help you make better decisions about diet, exercise, medication, and lifestyle.
And remember, managing hypertension doesn’t have to be overwhelming. Tools like Blueberry’s smart monitoring devices and team-based care system offer a complete solution—from tracking to treatment—to help you stay on top of your health.
