The Four Stages of Hypertension

General Health and Preventive Care  /  Blog

The Four Stages of Hypertension

Tessa Chatham Registered Nurse

Written by Tessa Chatham Registered Nurse

Tessa Chatham Registered Nurse

Tessa Chatham Registered Nurse

Tessa is a MSN prepared Registered Nurse with 12 years of critical care experience in healthcare. When not practicing clinical nursing, she enjoys academic writing and is passionate about helping those affected by medical aliments live healthy lives.

Renee Rulin, MD, MPH

Reviewed by Renee Rulin, MD, MPH

October 13, 2022 / Read Time 4 minutes

It is well known that high blood pressure can lead to severe illnesses, including heart attack, heart failure, stroke, and kidney disease. Blood pressure readings have been organized into “stages” to assist physicians and nurses in advising patients about optimal treatment, whether through traditional in-person visits or online doctor appointments.

Read on to learn about the stages of hypertension, the symptoms of each stage, and how to identify a hypertensive crisis.

What is Blood Pressure?

Blood pressure is literally the force of blood pushing against the walls of blood vessels and is measured using a blood pressure cuff. The systolic, or top number is the pressure generated during a heartbeat, and the diastolic, or bottom number is the pressure maintained between heartbeats. Blood pressure is usually described as the systolic “over” the diastolic.

What is a Normal Blood Pressure Reading?

According to the National Heart, Lung, and Blood Institute, the risk of cardiovascular disease begins at 115/75 and doubles with each increment of 20/10 mmHg.  Normal blood pressure is defined by a systolic number less than 120 and a diastolic number less than 80 (120/80).

What are the Stages of Hypertension?

As blood travels throughout your body, high blood pressure, or hypertension, can cause  microscopic damage to the inner lining of the arteries. This can lead to formation of plaques and blockages, resulting in damage to vital organs.

According to the American Heart Association, more than 103 million U.S. adults have high blood pressure. Hypertension can be organized into four stages, summarized in the table below.

Stages of Hypertension

Blood pressure category

Systolic (mmHg) upper number

Diastolic (mmHg) lower number



and Less than 80

Stage 1: high blood pressure (hypertension)


or 80-89

Stage 2: high blood pressure (hypertension)

140 or higher

or 90 or higher

Hypertensive crisis

Higher than 180

and/or Higher than 120

Prehypertension (Elevated)

Prehypertension, or elevated hypertension, is defined by a systolic number between 120-129 and a diastolic number less than 80. Having elevated blood pressure increases your risk of developing chronic, long-lasting, high blood pressure in the future.

Prehypertension can often be managed with lifestyle changes such as increasing physical activity, weight loss, and reducing salt intake. In general, blood pressure might go down by about 10 mmHg with each 10 lbs of weight lost.

Hypertension Stage 1

Hypertension stage 1 is defined by a systolic number between 130-139 or a diastolic number between 80-89. Many people live with undiagnosed hypertension stage 1, which is why it is important to have your blood pressure checked regularly. 

Treatment for hypertension begins with lifestyle changes:

  • Maintain a healthy weight. Aim for a body mass index (BMI) between 18.5 and 24.9.

  • Eat healthy. Eating lots of fruit, veggies, low-fat dairy, and less saturated and total fat can help.

  • Reduce sodium. Ideally, try to stay under 1,500 mg of sodium a day, but aim for at least a reduction of 1,000 mg per day.

  • Get active. Aim for at least 90 to 150 minutes of aerobic and/or dynamic resistance exercise per week and/or three sessions of isometric resistance exercises per week.

  • Limit alcohol. Drink no more than 1-2 drinks a day. (One for most women, two for most men)

Hypertension Stage 2

Hypertension stage 2 is defined by a systolic number between 140 or higher or a diastolic number higher than 90. Stage 2 hypertension is more serious, and the goal is to reduce blood pressure to normal ranges.

How Long Can You Live with Stage 2 Hypertension?

According to the American Heart Association, men with normal blood pressure could expect to live 5 years longer than those diagnosed with hypertension. Stage 2 hypertension can be treated with prescription medications and lifestyle modifications. Prolonged, untreated high blood pressure can lead to life-threatening medical conditions such as heart attack, stroke, and kidney disease.

What is a Hypertensive Crisis?

Hypertensive crisis is defined by a systolic number higher than 180 and/or a diastolic number higher than 120. If left untreated, a blood pressure of 180/120 or higher results in an 80% chance of death within one year, with an average survival rate of ten months.

Any blood pressure reading in this category is considered serious, and should be evaluated by a health care provider. 

Hypertensive crises are divided into two categories: urgent or emergent. Urgent hypertensive crisis is classified as a blood pressure reading of 180/120 or greater with no signs of organ damage. Emergency hypertensive crisis is a blood pressure reading greater than 180/120 with life-threatening damage to the body’s organs.

Treating the Stages of Hypertension

Our compassionate online doctors can help you address symptoms of hypertension at any stage. Hypertension is a treatable condition that can be cured. Blood pressure treatment can be done with prescription medications, lifestyle modifications, a low salt/low-fat diet, increased exercise, and stress reduction. 

Learn more about our hypertension treatment by making an appointment to speak with your PlushCare doctor. 

Read More About Stages of Hypertension


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