Elevated Blood Pressure

Elevated blood pressure is when your top (systolic) number is 120 to 129 mmHg and your bottom (diastolic) number is below 80 mmHg. Normally, the top number should be below 120.

Elevated blood pressure isn’t considered hypertension, or what most people call “high blood pressure.” But it’s a warning sign that you’re at risk of developing hypertension. Knowing your blood pressure is elevated gives you a chance to make some changes to lower it. A healthcare provider can help you create a plan that feels doable.

Symptoms of elevated blood pressure

Elevated blood pressure, which is slightly higher than a healthy level, doesn’t cause any symptoms. Using a blood pressure monitor — at your provider’s office or at home — is the only way to know if it’s raised. You also won’t have symptoms if you have hypertension. But extremely high blood pressure can cause headaches, nosebleeds and shortness of breath.

Elevated blood pressure causes

There’s usually not one specific cause of elevated blood pressure. Instead, many things can come together to raise your blood pressure a bit higher than it should be. Over time, these same things can cause your blood pressure to keep going up until you have hypertension.

You may develop elevated blood pressure if you:

• Often eat foods high in sodium (salt)
• Don’t get enough physical activity
• Drink too much alcohol
• Smoke, vape or use any tobacco products
• Have overweight
• Are sleep deprived
• Are stressed

The older you get, the greater your risk for elevated blood pressure or hypertension. The genes you’re born with can also affect your blood pressure.

How doctors diagnose elevated blood pressure

Elevated blood pressure isn’t an official diagnosis, like stage 1 or stage 2 hypertension. But it’s a helpful category that lets providers keep an eye on your blood pressure.

To measure your blood pressure, a provider will wrap a fabric cuff around your upper arm. They’ll gradually inflate it and then deflate it. You’ll feel a brief squeezing sensation. They may do this a couple of times to see if the numbers change after a few minutes, especially if you’re nervous.

Your provider may say your blood pressure is elevated if the top number is 120 to 129, but the bottom number is “normal” (below 80). They’ll usually use an average of two or more readings.

Sometimes, the blood pressure readings you get at your provider’s office are higher than they would be at home. This might be due to nerves or “white coat syndrome.”

If your provider thinks that’s the case, they may recommend using a device at home to measure and log your blood pressure. They may also prescribe you a device to wear that tracks your blood pressure for 24 hours. The results help you and your provider plan what to do next.

How is elevated blood pressure treated?

You typically don’t need medication to treat blood pressure that’s just a bit higher than it should be. Instead, your provider will talk with you about changes you can make in your daily life that can help lower your blood pressure. These include:

• Maintaining a healthy weight: You’ll work with your provider to set a goal that’s healthy for you. Losing at least 5% of your body weight may help treat elevated blood pressure. For example, if your weight is 200 pounds, you’d aim to lose 10 pounds.
• Following the DASH eating pattern: Research shows the DASH plan is the most effective way of eating to reduce blood pressure. This involves having plenty of whole grains, fruits, vegetables and lowfat dairy. It gives you lots of potassium, magnesium, calcium and fiber.
• Reducing sodium intake: Aim for no more than 2,300 milligrams (mg) of sodium per day. An ideal goal to treat elevated blood pressure is no more than 1,500 mg per day. Lowering your salt intake plus following the DASH plan is more helpful than doing either of those alone.
• Increasing potassium intake: Try to eat more foods rich in potassium, like bananas, leafy greens and beans. Ideally, get your potassium from food. It may also help to use salt substitutes that contain potassium (but only if your provider says these are OK for you).
• Moving around more: Planned cardio and resistance workouts can help lower your blood pressure. Ideally, get a mix of both types. Plus, try to add more movement to your daily routine, like by taking the stairs instead of the elevator or standing up every hour to stretch.
• Managing stress: It can be easier said than done. But trying to reduce the effects of stress can help you lower your blood pressure. Transcendental Meditation^® has the most evidence in its favor, especially when you use it along with dietary changes and exercise. 
• Reducing or avoiding alcohol: When it comes to lowering your blood pressure, the less alcohol you drink, the better. Avoid it completely if possible.

These tips can both help treat and prevent elevated blood pressure. So, if your blood pressure is in the healthy range now, doing these things can help you keep it that way.

When should I see my healthcare provider?

See a provider for a yearly check-up. They’ll measure your blood pressure at each visit and let you know if it’s elevated. Your provider may want you to come back more often for blood pressure checks. Be sure to follow the schedule they give you.

When changing your eating patterns, it may help to meet with a dietitian. They can help you find small, simple changes that can add up to big benefits over time.

What is prehypertension?

“Prehypertension” is an older term that healthcare providers don’t use anymore. It described blood pressure that wasn’t yet at the hypertension level. It meant:

• Your top number was 120 to 139 AND/OR
• Your bottom number was 80 to 89

Newer guidelines in the U.S. lowered the threshold for a hypertension diagnosis. Today, your provider will diagnose you with stage 1 hypertension if your top number is 130 to 139 and/or your bottom number is 80 to 89. They’ll say you have elevated blood pressure if your top number is 120 to 129 and your bottom number is below 80.

These ranges can vary outside the U.S. For example, the European Society of Cardiology defines elevated blood pressure as a top number of 120 to 139 and/or a bottom number of 70 to 89. They define hypertension as blood pressure that’s 140/90 or higher.