The Silent Number: What Your Blood Pressure Is Telling You
Nearly half of American adults have high blood pressure, and millions do not know it. Here is how to read your numbers, how to check them at home the right way, where to get a free reading, and when a high number is an emergency.
Why they call it silent
You can feel a headache or a sore back. You usually cannot feel high blood pressure. Many people walk around with it for years, feeling fine, while it quietly strains the heart, the blood vessels, the kidneys and the brain. That is why a simple number on a cuff matters so much.
Those numbers come from a national CDC survey that measured blood pressure in people across the country from 2021 to 20231. High blood pressure was more common with age, affecting about 1 in 4 adults under 40 and more than 7 in 10 adults 60 and older1.
What your numbers mean
A blood pressure reading has two numbers. The top number (systolic) is the pressure when your heart beats. The bottom number (diastolic) is the pressure between beats. Here are the categories the American Heart Association uses2.
- 01NormalUnder 120 and under 80Keep up healthy habits and check regularly.
- 02Elevated120 to 129 and under 80Not yet high blood pressure, but worth watching.
- 03Stage 1130 to 139 or 80 to 89High blood pressure. Talk to your doctor about next steps.
- 04Stage 2140 or higher or 90 or higherHigh blood pressure. See your doctor soon.
- 05SevereHigher than 180 and/or higher than 120Wait a minute and check again. See the emergency steps below2.
Only one of the two numbers needs to be in a higher range to put you in that category. For example, 128 over 84 counts as Stage 1 because of the bottom number2.
How to check your blood pressure at home
Home readings can give your doctor a truer picture than one rushed check in the office. But small mistakes, like talking or crossing your legs, can throw off the number. The American Heart Association recommends these steps3.
- No caffeine, smoking, alcohol or exercise for 30 minutes before
- Empty your bladder
- Sit quietly for 5 minutes without talking
- Back supported, feet flat on the floor, legs uncrossed
- Arm resting on a table at heart level
- Cuff on bare skin above the elbow, not over a sleeve
- Take at least two readings about one minute apart
- Write them all down and share them with your doctor
Use a monitor that has been checked for accuracy, with a cuff that fits your arm3. The American Medical Association supports a free list of validated home blood pressure monitors at validatebp.org4.
Caffeine can affect your reading, and the FDA lists high blood pressure among the effects of too much caffeine. Our guide to caffeine and sleep shows how to cut back gently.
When a high number is an emergency
If your reading is higher than 180 on top or higher than 120 on the bottom, wait one minute and measure again. If it is still that high, check for warning signs2.
- Chest pain
- Shortness of breath
- Back pain
- Numbness or weakness
- Change in vision
- Trouble speaking
If the reading stays above 180/120 but you have none of those symptoms, contact your doctor right away2.
Where to get your blood pressure checked
You do not need an appointment to find out your numbers.
- Pharmacies. Many drugstores have free blood pressure machines or will check it for you.
- Community health centers. Federally funded health centers offer care on a sliding fee scale based on income. Search for one near you at findahealthcenter.hrsa.gov.
- Health fairs and churches. Many churches host free blood pressure checks, often run by a nurse in the congregation.
- Your doctor. Ask for a reading at every visit, and ask what your numbers mean for you.
Why the church can help
Churches have something many clinics do not: people who know and trust each other, week after week. Researchers have tried to use that. In a study across 32 New York City churches, Black adults with uncontrolled blood pressure joined an 11 week program that combined healthy lifestyle lessons with prayer and Scripture, led by community health workers. After six months, their top number had dropped by about 6 points more than a comparison group that received standard health education. The difference had faded by nine months, which suggests ongoing support matters5.
If your church has a nurse, a health ministry or even a blood pressure cuff, a monthly check after service could help someone find out their number for the first time.
Keep thy heart with all diligence; for out of it are the issues of life.
Frequently asked questions
What is a normal blood pressure?
The American Heart Association considers a reading under 120 on top and under 80 on the bottom to be normal2.
What blood pressure is considered high?
A reading of 130 or higher on top, or 80 or higher on the bottom, falls in the high blood pressure range2. Your doctor will usually look at several readings before making a diagnosis.
Can you feel high blood pressure?
Usually not. Most people with high blood pressure have no symptoms, which is why so many people do not know they have it1.
What is the best time to check blood pressure at home?
Many people check in the morning and evening. Whatever time you choose, follow the same steps each time and take at least two readings a minute apart3.
Stress and poor sleep can both affect your health. Read how stress affects your prayer life and Lying awake at 3 AM, or try a gentle week of movement.
Free, written by the editors. Unsubscribe in one click.