Hypertension (high blood pressure) is divided into stages based on the severity of the condition. These stages include elevated, stage 1, stage 2, and hypertensive crisis.

Doctors stage hypertension based on the severity of the reading. Healthcare professionals test blood pressure as part of routine care.

People can also monitor their blood pressure at home and share their readings with their healthcare professional. Elevated and high blood pressure levels can be a cause for concern and may require lifestyle changes, medications, or both.

This article lists and explains the stages of hypertension. It also discusses primary and secondary hypertension and when it is considered an emergency.

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The stages of hypertension (high blood pressure) are based on the readings a healthcare professional or the individual gets using a blood pressure monitor.

A normal blood pressure reading indicates a person is within a healthy range.

Higher readings indicate a person may be in one of four stages of hypertension.

Normal blood pressure readings

Normal blood pressure readings for adults are typically defined as a systolic pressure (top number) of less than 120 millimeters of mercury (mm Hg) and a diastolic pressure (bottom number) of less than 80 mm Hg.

People with normal blood pressure should continue to make heart-healthy choices, which can include regular exercise and a balanced diet with plenty of fruits, vegetables, and lean proteins.

Most people will not know or recognize the difference between normal blood pressure and high blood pressure. Regularly checking blood pressure, through wellness visits or home monitoring, is the only way most people will know if they develop high blood pressure, as there are rarely any symptoms.

Elevated

Elevated blood pressure occurs when a person’s blood pressure readings are slightly higher than normal.

A person with elevated blood pressure has a systolic (top number) pressure between 121 and 129 mm Hg and a diastolic (bottom number) pressure of less than 80 mm Hg.

At this stage, a healthcare professional may recommend more regular check-ins to monitor a person’s blood pressure. They will likely recommend a person adopt a healthier lifestyle to help bring their blood pressure down.

This may include:

  • quitting smoking
  • limiting or avoiding alcohol
  • avoiding foods with high saturated fat, cholesterol, or added sugar
  • maintaining a moderate weight
  • getting regular exercise or physical activity, such as playing a sport

Stage 1

Stage 1 hypertension means a person has a systolic (top number) pressure between 130 and 139 mm Hg or a diastolic (bottom number) pressure between 80 and 89 mm Hg.

At this stage, healthcare professionals often advise individuals to make lifestyle changes to help get their blood pressure down.

They may also consider adding medication to help lower the person’s blood pressure.

Stage 2

Stage 2 hypertension means a person has a systolic (top number) pressure of 140 mm Hg or higher or a diastolic (bottom number) reading of 90 mm Hg or higher.

A person with stage 2 hypertension will likely be prescribed a combination of medications and lifestyle changes.

Hypertensive crisis

A hypertensive crisis occurs when blood pressure rises quickly to a systolic (top number) pressure of 180 mm Hg or higher or a diastolic (bottom number) pressure of 120 mm Hg or higher.

A person may require emergency treatment if their pressure does not come down or they experience symptoms such as chest pain or shortness of breath.

Learn more about hypertensive crisis.

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Hypertension can also be classified as primary or secondary.

Primary

If a person has primary hypertension — also known as essential — it means they cannot trace their high blood pressure to an underlying health condition.

In other words, it occurs and develops on its own, typically over the course of several years.

It is more common than secondary hypertension. Experts suggest a high salt diet combined with a person’s inability to process it correctly may be a primary underlying cause of its development.

Treatment and management of primary hypertension typically involve lifestyle changes and medications as needed.

Secondary

Secondary hypertension occurs due to the presence of an underlying health condition, such as a kidney disorder, endocrine disorder, and certain medications.

Secondary hypertension occurs in about 10% of people living with high blood pressure.

Treatment for secondary hypertension usually consists of treating high blood pressure with medications and lifestyle changes as well as addressing the underlying condition.

In some cases, a person may rapidly develop high blood pressure. There are two crisis situations: emergency and urgency. Both require immediate treatment.

Emergency

Emergency hypertension occurs when a person’s blood pressure reads 180/120 mm Hg or higher.

A person will also typically develop symptoms that can include one or more of the following:

A person experiencing these symptoms and high blood pressure should seek immediate medical attention by contacting emergency services or calling 911.

Urgency

Hypertension urgency occurs when a person’s blood pressure reads as 180/120 mm Hg or higher but no other symptoms are present.

If a person takes a reading that shows high blood pressure, they should wait 5 minutes and retest. If the second reading is just as high but no other symptoms develop, a person should contact a healthcare professional.

A healthcare professional may make adjustments to the person’s medication or suggest other management options.

Can stage 2 hypertension be reversed?

No treatment can completely cure hypertension. However, regularly taking blood pressure medications can help lower blood pressure, along with making lifestyle changes, such as maintaining a moderate weight, eating a healthy and balanced diet, and getting regular exercise.

What is dangerously high blood pressure?

Experts consider blood pressure that is 180/120 mm Hg or higher as an urgent or emergency situation. It is urgent if no other symptoms are present and may only require speaking with a healthcare professional to adjust medications.

It is an emergency situation if other symptoms, such as chest pain or dizziness, also appear. This requires immediate medical care.

Blood pressure resources

Visit our dedicated hub for more research-backed information and in-depth resources on managing high blood pressure.

Experts classify hypertension into stages, including elevated, hypertension stage 1, hypertension stage 2, and hypertensive crisis. These stages are based on how high a person’s blood pressure is.

High blood pressure does not typically cause symptoms, even at higher stages. The only way to know is to check blood pressure readings at home or at a healthcare facility.

Changes in lifestyle, including getting exercise, eating healthy foods, maintaining a moderate weight, and avoiding or quitting smoking can help lower blood pressure. Sometimes, medications may also be necessary to help lower blood pressure.

A person should call 911 right away if they have unusually high blood pressure and develop symptoms, such as dizziness, changes in vision, or chest pain.