What does the top number on your blood pressure mean

Blood pressure is a key indicator of how well the cardiovascular system is functioning and can signal many diseases and conditions.

“It measures the pressure of blood flow to the vascular system. This is necessary for all the organs in the body to receive adequate nutrition and oxygen to function,” said Navid Kazemi, MD, cardiologist and chair of MountainView Hospital Cardiac Services Department.

There is a healthy blood pressure range, and having too high or too low blood pressure can cause serious, long-term health consequences. Unfortunately, the importance of healthy blood pressure often is overlooked, and many people with poor blood pressure may not realize they’re at risk.

Decoding your blood pressure reading

According to the American Heart Association, an optimal blood pressure range is at or less than 120/80 mmHg. This is what those numbers mean:

  • The top number (120) is your “systolic blood pressure.” It indicates how much pressure the blood is exerting while the heart is actively pumping into the blood vessels.
  • The bottom number (80) is your “diastolic blood pressure.” It indicates how much pressure the blood is exerting between pumps. “Diastolic blood pressure is the baseline pressure in the blood vessels when the heart is resting,” Kazemi said.
  • “mmHg” is the abbreviation for “millimeters of mercury.” Mercury is used to gauge pressure in many medical measurements.

Which number is most important?

Both. Having a high number in either systolic or diastolic pressure can lead to a diagnosis of hypertension (high blood pressure). However, systolic pressure tends to get more attention because high systolic blood pressure is a risk factor for cardiovascular disease for people over 50, and it can indicate major cardiac events.

Also note: Heart rate and blood pressure are not the same, and they can indicate different issues. The American Heart Association reports that blood pressure measures the force that blood moves through blood vessels, and heart rate measures the amount of times your heart beats per minute. Having a healthy heart rate does not necessarily mean your blood pressure is in a healthy range. Both measurements are important, but one does not replace the other.

Hypertension (high blood pressure)

Hypertension, the clinical term for high blood pressure, is a common and dangerous condition. “It causes persistent strain on both the heart and the blood vessels, which can lead to serious dysfunction,” Kazemi said. “This can manifest as weakening of the heart, as well as damage to the blood vessels, causing various organ failure in the long-term.”

There may be some symptoms that accompany hypertension — such as fatigue, shortness of breath and headaches — but in general, the condition shows no typical symptoms.

Hypertension can cause stroke, acute kidney failure, heart attack and blindness, among other ailments.

Risk factors for hypertension include age, high body weight, low activity level, poor diet, smoking, excessive alcohol consumption, high stress levels, certain chronic diseases (including diabetes) and a family/personal history with the condition.

Blood pressure naturally gets higher with age. In people younger than 60, 140/90 mmHg is considered high, but in people older than 60, 150/90 mmHg is acceptable.

What about low blood pressure?

Hypotension, or low blood pressure, is less common than hypertension, but it can cause serious health consequences. Chronic low blood pressure is associated with organ failure because not enough oxygen can circulate throughout the body.

When to get blood pressure readings

“A normal person who has never has high blood pressure does not require regular readings beyond their yearly check-ups,” Kazemi said. “Patients with a history of hypertension should be checked more frequently.” Talk to your doctor about how often you should have your blood pressure checked, and follow that schedule closely.

Habits for promoting healthy blood pressure

Blood pressure is greatly influenced by lifestyle, so most healthy people can properly manage blood pressure without medical intervention.

“Keeping body weight within a normal range, eating a heart-healthy diet, decreasing mental stress and having a regular aerobic exercise routine can have a profound effect on blood pressure,” Kazemi said.

What does the top number on your blood pressure mean

At a recent appointment, your doctor says, “You’ll be happy to hear your blood pressure is down from 140 over 90 to 120 over 80.”

“Great news!” you reply. But what do these fraction-like numbers actually mean?

Don’t worry. You won’t need advanced math skills to figure it out.

First, let’s get a better understanding of what blood pressure is. Picture your blood vessels and arteries as tubes. Blood is trying to go from one side of the tube to the other. As the blood moves, it’s pushing against the tube or vessel’s walls. That force is blood pressure.

How to Read Blood Pressure Numbers

What does the top number on your blood pressure mean

Now let’s explore the measurement. Blood pressure is always shown as two numbers. Use 120 over 80, which is written as 120/80 mm Hg (millimeters of mercury), as an example. The “120” is the top number and is known as systolic blood pressure. It represents the pressure in your arteries when your heart beats. The “80” is the bottom number and is known as diastolic blood pressure. This is the pressure measured between your heartbeats when your heart is relaxing.

While both numbers are important, the American Heart Association notes the top number usually gets more attention. That’s because it helps show your risk of having a stroke or heart attack, along with kidney disease, congestive heart failure, vision loss and memory loss.

A high systolic reading is considered a major heart disease risk factor for people older than 50. As we age, arteries can become stiff and develop plaque buildup. In other words, if your blood is essentially punching the walls inside your heart, over and over again, damage will eventually occur.

Here’s how the American Heart Association categorizes blood pressure levels.

  • Normal: systolic less than 120 and diastolic less than 80
  • Prehypertension: systolic 120-139 or diastolic 80-89
  • Stage 1 high blood pressure: systolic 140-159 or diastolic 90-99
  • Stage 2 high blood pressure: systolic 160 or higher or diastolic 100 or higher
  • Hypertensive crisis (seek emergency care): systolic higher than 180 or diastolic higher than 110

Low blood pressure is typically not a problem unless you notice symptoms like:

  • Dizziness
  • Fainting
  • Lack of concentration
  • Blurred vision
  • Nausea
  • Clammy skin
  • Shallow breathing
  • Fatigue
  • Depression

How Often You Should Check Your Blood Pressure

The American Heart Association recommends checking your blood pressure beginning at age 20 and measuring it every two years if it’s normal. If it’s high, your doctor will want to see you more often, especially if you are controlling it with medication. A primary care doctor can check your blood pressure and take steps to help you keep it well controlled. Talk to your doctor if you have concerns about your blood pressure.

Remember: Even extremely high blood pressure levels may not cause noticeable symptoms. Get to the emergency department or call 911 if you have weakness on one side, slurred speech, severe headaches, or vision changes such as blind spots or blurred vision.

What does it mean when the number on top of your blood pressure is high?

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.

Which is worse for blood pressure the top or bottom number?

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.

What is a good top number for BP?

For a normal reading, your blood pressure needs to show: a systolic pressure that's above 90 mm Hg and less than 120 mm Hg, and. a diastolic pressure that's between 60 mm Hg and less than 80 mm Hg.

What is ideal blood pressure by age?

Normal Blood Pressure By Age Both Male and Female.