Health
Think your blood pressure is normal? You might want to check again
Blood pressure guidelines are changing and your doctor may recommend treating hypertension sooner rather than later. Here’s everything you need to know.
By Sabrina Rogers-Anderson
Confused about what your blood pressure reading should be? With various medical bodies around the world setting different guidelines and targets, it can be hard to know what’s healthy or cause for concern.
In Australia, more than 1 in 10 people have high blood pressure (hypertension) with rates nearly tripling between 35 to 44 years (4.7%) and 45 to 54 years (12.4%).
Because ongoing high blood pressure can lead to health issues including heart disease, heart attack, stroke, kidney disease, eye conditions and dementia, it’s important to get on top of it early.
Here’s everything you need to know about keeping your blood pressure in check.
What is blood pressure?
Blood pressure is the force with which your blood pumps through your arteries (blood vessels). When you have high blood pressure, the blood pumps through your arteries with more force than normal.
A blood pressure reading is made up of two numbers measured in millimetres of mercury (mmHg) and written as, for example, 120/80mmHg. The two numbers are:
- Systolic blood pressure: The top number indicates the peak beat-to-beat pressure as your blood pumps through your arteries.
- Diastolic blood pressure: The bottom number is the lowest beat-to-beat pressure in your arteries, which is when your heart relaxes between beats.
Why does the definition of high blood pressure keep changing?
In Australia and Europe, high blood pressure is defined as 140/90mmHg and above.
American guidelines used to be the same, but the American College of Cardiology/American Heart Association (ACC/AHA) lowered the threshold for high blood pressure to 130/80mmHg in 2017 and further tightened its management guidelines in 2025.
Now, the Australian Heart and Stroke Foundations are reviewing the existing literature to develop new guidelines that may mirror the American ones.
“There's never complete alignment between the European, American and Australian guidelines, but the core definition remains,” says Professor Jason Kovacic, Director and CEO of the Victor Chang Cardiac Research Institute.
“Optimal blood pressure is less than 120/80mmHg and normal blood pressure is in the range of 120/80mmHg to 130/85mmHg. Once we get above that, we need to consider at what point to introduce treatment.
“Previously, we would have waited to treat marginal blood pressures in the 130/80mmHg to 140/90mmHg range unless there were additional risk factors like diabetes or previous cardiovascular disease or stroke. We would have simply suggested lifestyle changes and kept an eye on it.
“But now, the impetus to treat that range of blood pressure with a combination of medication and lifestyle changes is growing. The data showing that we should intervene earlier is stacking up, and we have multiple blood pressure medications that are cheap, effective and safe.”
When should I see my doctor?
You should have your blood pressure checked every two years – or more often if recommended by your GP or specialist. If your blood pressure is above 120/80mmHg, talk to your doctor about the best course of action for you.
“Have a conversation with your physician about your overall risk and what the threshold should be for treating your blood pressure,” says Professor Kovacic. “But at the end of the day, it’s your decision.”
What are the symptoms of high blood pressure?
Most people with high blood pressure don’t experience any symptoms. The only way to know for sure if you have high blood pressure is to have it checked.
Some people with very high blood pressure may experience:
- Dizziness
- Headaches
- Confusion
- Nosebleeds
- Eyesight issues
- Vomiting
- Chest pain
- Shortness of breath
- Seizures
If left untreated, high blood pressure can lead to heart attack, stroke, kidney disease, dementia and other serious conditions.
What causes high blood pressure?
While the cause of high blood pressure is unknown in most people, a number of factors can increase your risk of developing it. These include:
- A family history of high blood pressure
- Being overweight or obese
- Lack of exercise
- A diet high in salt
- Heavy drinking of alcohol
- Smoking
In some cases, a specific cause of high blood pressure can be identified, including:
- Some medications including the contraceptive pill and non-steroidal anti-inflammatories
- Kidney disease
- Narrowing of the arteries to the kidneys
- Sleep apnoea
- Some hormonal conditions
“Whatever the possible cause, you shouldn’t feel guilty or berate yourself,” says Professor Kovacic. “It’s never too late to make lifestyle changes like quitting smoking or losing weight. At all stages of life, these changes are known to be beneficial.”
How is high blood pressure diagnosed?
Your doctor will measure your blood pressure using a sphygmomanometer or automated blood pressure monitor that has an inflatable cuff that goes around your upper arm.
They may also perform a physical exam and ask you questions about your family medical history, your lifestyle and any medications you take.
If your blood pressure is high, they may ask you to check your blood pressure regularly at home or wear a blood pressure monitor for 24 hours to check how your blood pressure varies throughout the day.
Your doctor may also want you to undergo additional tests to rule out other health conditions.
How is blood pressure treated?
Some people may be able to lower their blood pressure with lifestyle changes alone. These include:
- Getting your weight down into the healthy range
- Exercising regularly
- Quitting smoking
- Limiting alcohol
- Eating a healthy diet high in fibre and low in salt and saturated fat
When lifestyle changes aren’t enough or your blood pressure is too high, your doctor may recommend a blood pressure medication (antihypertensive) to lower it and reduce your risk of complications such as heart attack and stroke.
Blood pressure medications include ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers and diuretics.
Where to get support
Want more information? Try these resources:
- Victor Chang Cardiac Research Institute: A trusted source of information for many heart and vascular issues.
- Hypertension Australia: Find helpful fact sheets on high blood pressure and how to manage it
- The Heart Foundation (13 11 12): Information and support for people with high blood pressure and heart conditions
- The Stroke Foundation (1800 787 653): Find out how to reduce your risk of stroke by managing your blood pressure
The information on this page is general information and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice. Any information you find on this page or on external sites which are linked to on this page should be verified with your professional health care provider.
Feature image: iStock/milan2099
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