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Blood pressure: the number and what to do
The single most treatable risk factor for stroke and heart disease.
The ESC categories: optimal under 120/80, normal 120-129/80-84, high-normal 130-139/85-89, and hypertension from 140/90. Most hypertension is silent — the first symptom can be the stroke — which is why the measurement is the screening: once a year for every adult, properly (seated, rested, right cuff size, average of two).
The treatment ladder starts with the boring levers — salt down, alcohol down, weight down, movement up — and every one of them moves the number by roughly the same order as a drug. When drugs are needed they are old, cheap and effective, and the modern standard is two at low dose rather than one at high dose.
The numbers
- Hypertension threshold: 140/90 mmHg (ESC).
- High-normal: 130-139/85-89 — the warning band.
- Each 10 mmHg of systolic lowering cuts events by roughly a fifth (published meta-analyses).
Source: ESC — 2021 guidelines on cardiovascular disease prevention · checked 2026-09-07
Reference, not medical advice. Your targets are set by a clinician from your total risk. Chest pain, breathlessness at rest or fainting are emergency symptoms — get help, do not read on.