Why it's called the silent killer
High blood pressure usually causes no symptoms at all. While you feel perfectly fine, it can spend years damaging the blood vessels of your heart, brain, kidneys and eyes. It's a leading cause of heart attack, stroke, kidney failure and heart failure. The only way to know is to measure it.
What your numbers mean
Categories from the American Heart Association's 2025 guideline (mm Hg):
| Category | Top number (systolic) | Bottom number (diastolic) | |
|---|---|---|---|
| Normal | Below 120 | and | below 80 |
| Elevated | 120–129 | and | below 80 |
| High, stage 1 | 130–139 | or | 80–89 |
| High, stage 2 | 140 or higher | or | 90 or higher |
A reading above 180/120 with chest pain, shortness of breath, weakness, or changes in vision or speech is an emergency: call for help right away.
How to measure at home the right way
- Use a validated monitor with an upper-arm cuff. Don't rely on smartwatch readings yet.
- No coffee, tea, smoking or exercise for 30 minutes before. Empty your bladder, then sit quietly for 5 minutes with your back supported and feet flat on the floor.
- Rest your arm on a table at heart level, with the cuff on bare skin. Don't talk during the reading.
- Take two readings a minute apart, morning and evening, for a week. Write them down and show your doctor.
What brings it down
- Less salt: pickles, papadam, dried fish, vadam, packaged snacks and restaurant food are all high in salt.
- More potassium-rich food: vegetables, greens, fruit and lentils (if you have kidney disease, ask your doctor first).
- Lose extra weight and get at least 150 minutes a week of activity like brisk walking.
- Cut down on or stop alcohol, stop smoking, and manage stress.
- If you snore loudly, get checked for sleep apnea, which also raises blood pressure.
When is medication needed?
The guideline says that if your average is 140/90 or higher, you need medication along with lifestyle changes. Above 130/80, medication may also be started if you have diabetes, kidney disease, heart disease or a high heart risk. Once you start, don't stop on your own because you "feel fine": normal readings are the sign the medicine is working.
Sources
- American Heart Association: 2025 High Blood Pressure Guideline, top things to know
- American Heart Association scientific statement: Atherosclerotic cardiovascular disease in South Asians (Circulation, 2018)
Facts and prices checked on: 2026-10-27