The top number, systolic pressure, is the pressure in your arteries when the heart contracts. The bottom number, diastolic, is the pressure between beats. Both are measured in millimetres of mercury. In adults over about 50, systolic pressure is the stronger predictor of cardiovascular risk, largely because arteries stiffen with age; in younger adults, diastolic carries more weight.

The categories

Widely used US thresholds classify under 120/80 as normal; 120–129 systolic with diastolic under 80 as elevated; 130–139 or 80–89 as stage 1 hypertension; and 140/90 or above as stage 2. Above 180/120 is a hypertensive crisis: repeat after five minutes of rest, and if it stays there, seek urgent care — immediately if it comes with chest pain, breathlessness, weakness or numbness on one side, difficulty speaking, or visual change. These are population thresholds, and the target your clinician sets for you may differ.

Why home readings are worth taking

Clinic readings are noisy. White-coat hypertension — raised in the clinic, normal at home — affects a meaningful share of people and can lead to unnecessary treatment. Masked hypertension is the reverse and is more dangerous, because it goes untreated. Home averages over several days correlate better with cardiovascular outcomes than one-off office readings, which is why a well-kept log genuinely changes decisions.

What changes the numbers

Sodium reduction, potassium-rich eating patterns such as DASH, weight loss, regular aerobic activity, limiting alcohol, and better sleep all lower blood pressure measurably; the effects add up. In the other direction, decongestants containing pseudoephedrine, regular NSAID use, some antidepressants, oral contraceptives, liquorice, stimulants and untreated sleep apnoea all raise it. So does a full bladder, a conversation during measurement, or an unsupported arm — which is why technique keeps coming up.