Doctors split high blood pressure into different levels of severity. Do you know which one you have? And why should you care? All shall be revealed…

Let’s deal with that second question first, as it’s the most important. Why should you care? Don’t you just need to get your blood pressure down to target? In which case it would be irrelevant what level it was to begin with.


How high is too high?

Actually, how high your blood pressure is to start with does influence how we recommend treating it. This is because for milder high blood pressure (called stage 1 hypertension), there isn’t good evidence that medication will do you much good (by which I mean reduce your risk of heart attacks and strokes).

So, we shouldn’t be giving medication to people with milder high blood pressure. Instead people with milder high blood pressure should be encouraged to do the usual healthy things (exercise, control their weight, avoid salt and alcohol) and just monitor their blood pressure to check it doesn’t increase to ‘stage 2’. If your blood pressure is high enough to be classed as ‘stage 2’ then there is good evidence that medication will be of benefit.


So, again, why should I care?

The reason you should care about this is that it is suspected (no-one knows for sure) that there are many people out there who are being given medication for stage 1 hypertension. And yet we have no evidence that this does them any good. So, what level of blood pressure is classed as ‘stage 1’ and ‘stage 2’?

Home blood pressure readings:

Stage 1 hypertension: 135/85 – 149/94 mmHg

Stage 2 hypertension: 150/95 mmHg and higher

Remember, this is your blood pressure when you were diagnosed. Not the level it is at now if you are taking medication.


Help, I think I’m being medicated for stage 1 hypertension!

So, what should you do if you suspect that you are one of the many people who may be taking medication unnecessarily for stage 1 hypertension? Well, the first thing to stress is that this only applies to people who have no other significant health conditions. If you have diabetes, chronic kidney disease, high cholesterol, have had a heart attack or stroke etc etc then it is likely that you WILL benefit from treatment of stage 1 high blood pressure. Your doctor can advise you whether you have any relevant conditions.

Otherwise, hopefully either you or your doctor will have a record of your blood pressure readings at the time you were diagnosed. If they are in the stage 1 range then it would be worth having a chat about whether you wish to take medication or not.


This advice is based upon guidance that is published for doctors in the UK. We are aware that in other parts of the world practices may differ.

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