What do top and bottom bp numbers mean

Overview

What do your blood pressure numbers mean?

Blood pressure is a measure of the force of blood against the walls of your arteries. Blood pressure readings include two numbers. The first number is the systolic pressure (top number). This is the force of blood on the artery walls as your heart pumps. The second number is the diastolic pressure (bottom number). This is the force of blood on the artery walls between heartbeats.

If the top number stays high, or the bottom number stays high, or both, that means you have high blood pressure (hypertension). It's normal for blood pressure to go up and down throughout the day. Your doctor will give you a goal for your blood pressure.

What can cause blood pressure to go up or down?

It's normal for blood pressure to go up and down throughout the day. Things like exercise, stress, and sleeping can affect your blood pressure. Some medicines can cause your blood pressure to go up. These medicines include certain asthma medicines and cold remedies.

A low blood pressure reading can be caused by many things, including some medicines, a severe allergic reaction, or an infection. Another cause is dehydration, which is when your body loses too much fluid.

When should you call your doctor?

One high or low blood pressure reading by itself may not mean you need to call for help. If you take your blood pressure and it is out of the normal range, wait a few minutes and take it again. If it's still high or low, use the following guidance.

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • Your blood pressure is much higher than normal (such as 180/120 or higher).
  • You think high blood pressure is causing symptoms such as:
    • Severe headache.
    • Blurry vision.
  • You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your blood pressure measures higher than your doctor recommends at least 2 times. That means the top number is higher or the bottom number is higher, or both.
  • You think you may be having side effects from your blood pressure medicine.

Credits

Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine

Find out how to understand blood pressure readings and use our blood pressure chart to see how healthy your blood pressure is.

What does a blood pressure reading look like?

When you have your blood pressure measured, you will be given two numbers, a top number and a bottom number.

  • Systolic blood pressure. This is the first, or top, number. This is the highest level your blood pressure reaches when your heart beats, forcing blood around your body.
  • Diastolic blood pressure. The second number, or bottom number, is the lowest level your blood pressure reaches as your heart relaxes between beats.

Blood pressure is measured in millimetres of mercury (mmHg). If the first number is 120 and the second number is 80, this would be written as 120/80mmHg, and you’d call it ‘120 over 80’.

This video explains more about systolic and diastolic blood pressure.

The blood pressure chart

Once you know your numbers, you can use the blood pressure chart to see what they mean and if your blood pressure is in the healthy range. The chart is suitable for adults of any age, as the cut-off point for diagnosing high blood pressure doesn’t change with age.

What do top and bottom bp numbers mean

How to use the blood pressure chart

Simply find your top number (systolic) on the left side of the chart and your bottom number (diastolic) on the bottom. Where the two lines meet is your blood pressure.

Download the chart.  Blood pressure chart for adults - PDF [PDF 121KB]

What do the readings mean?

As a general guide:

140/90mmHg or over – you may have high blood pressure
Most doctors use 140/90mmHg as the cut off for point for diagnosing high blood pressure (hypertension). This is the point where your risk of serious health problems goes up. They might prescribe medications and advise you to make changes to your lifestyle to bring your blood pressure down.

120/80mmHg up to 140/90mmHg – pre-high blood pressure
Also called high-normal blood pressure. This is not high blood pressure, but it is a little higher than it should be and means you could go on to develop high blood pressure. See how you can make healthy changes to your lifestyle to lower it.

90/60mmHg up to 120/80mmHg – ideal blood pressure
Also called normal blood pressure. Your blood pressure reading is healthy. At this level you have a much lower risk of heart disease and stroke. Following a healthy lifestyle will help you to keep it in the healthy range.

90/60mmHg or lower – you may have low blood pressure
Low blood pressure usually isn’t a problem, but it can sometimes make you feel faint or dizzy or could be a sign of another health problem.

The video below explains how your blood pressure numbers are linked to the risk of stroke and other disease.

Diagnosing high or low blood pressure

Only one of your numbers needs to be higher than it should be to be diagnosed with high blood pressure, and only one needs to be lower than it should be to be diagnosed with low blood pressure.

So if your top number is over 140 or the bottom number is over 90, you may be diagnosed with high blood pressure, regardless of the other number. If your top number is under 90 or your bottom number is under 60, you may be diagnosed with low blood pressure. Use the chart to see where your numbers sit.

If your top number (systolic pressure) is consistently higher than 140mmHg, but the bottom number is healthy - this is known as Isolated Systolic Hypertension. If the bottom number (diastolic pressure) is consistently higher than 90mmHg but the top number is healthy - this is known as Isolated Diastolic Hypertension.

Making sure your readings aren’t a one-off

A single high reading doesn’t necessarily mean you have high blood pressure, as many things can affect your blood pressure throughout the day, such as the temperature, when you last ate, and if you’re feeling stressed.

Your doctor or nurse will probably want to measure your blood pressure a number of times over a few weeks to make sure the reading wasn’t just a one off and that your blood pressure stays high over time. 

Read about how high blood pressure is diagnosed, getting a blood pressure check, the further tests you might have if you have a high blood pressure reading, and what it means if you’re diagnosed with high blood pressure.

Which is more important systolic or diastolic blood pressure?

Over the years, research has found that both numbers are equally important in monitoring heart health. However, most studies show a greater risk of stroke and heart disease related to higher systolic pressures compared with elevated diastolic pressures.

When should you worry about the bottom number of blood pressure?

Over time, isolated diastolic hypotension can cause heart failure. In fact, it may be one of the most common causes of heart failure. Pay attention to your diastolic number when you have your blood pressure checked. If your lower number is 60 or below, ask a healthcare professional about it.

What causes the bottom number to be high on blood pressure?

Diastolic pressure is the bottom number of a blood pressure reading. IDH occurs if someone has elevated diastolic blood pressure, increasing a person's risk of heart disease and stroke. Smoking, consuming alcohol, obesity, and high blood fat may lead to IDH.

What is ideal blood pressure by age?

Normal Blood Pressure By Age Both Male and Female.