Share
Written by Dr Serena Jones, GP
Dr Serena graduated from Manchester University in 2008 (MBChB).
She also holds the MRCGP, DRCOG and DFSRH.
One of the most common long-term conditions we see in everyday General Practice is high blood pressure (hypertension). Around one in three adults in the UK is affected, often without realising it. Because it usually causes no symptoms, high blood pressure is sometimes called a “silent killer” — yet over time it significantly increases the risk of heart disease, stroke, kidney disease and vascular dementia. Understanding the different stages of high blood pressure helps patients recognise risk early and take action before complications develop.
What Is Blood Pressure?
Blood pressure is a measure of the force of blood pushing against the walls of the arteries. It is recorded as two numbers:
Systolic pressure – the pressure when the heart contracts
Diastolic pressure – the pressure when the heart relaxes between beats
For example, a reading of 120/80 mmHg means a systolic pressure of 120 and a diastolic pressure of 80.
Normal Blood Pressure
A normal blood pressure reading is usually:
Below 135/85 mmHg when measured at home, or
Below 140/90 mmHg when measured in a clinic
For some people — particularly those with chronic kidney disease, diabetes or cardiovascular disease — lower targets may be recommended.
The ideal blood pressure for most adults is around 120/80 mmHg. At this level, the risk of cardiovascular disease is low. Maintaining a healthy lifestyle, including regular exercise, a balanced diet, reducing salt intake and avoiding smoking, plays a key role in keeping blood pressure within this range.
Stage 1 Hypertension: Mildly Raised Blood Pressure
Stage 1 hypertension is diagnosed when clinic readings are:
Systolic: 140–159 mmHg
Diastolic: 90–99 mmHg
At this stage, cardiovascular risk begins to increase. Treatment decisions are based on a person’s overall risk profile, including age, family history, diabetes, kidney disease and any existing heart or vascular disease.
Some patients can initially manage stage 1 hypertension with lifestyle changes alone, while others will benefit from starting medication earlier.
Stage 2 Hypertension: Moderately Raised Blood Pressure
Stage 2 hypertension is defined as blood pressure readings of:
160/100 mmHg or higher
This level of blood pressure is associated with a significantly increased risk of heart attack, stroke and organ damage. Most patients will require blood pressure-lowering medication, alongside ongoing lifestyle changes. Regular review and monitoring are essential to ensure blood pressure is brought under control.
Severe (Stage 3) Hypertension
A blood pressure reading of 180/120 mmHg or higher is considered severely elevated and requires urgent medical assessment, particularly if accompanied by symptoms such as:
- Chest pain
- Shortness of breath
- Visual disturbance or confusion
- Severe headaches
Why Monitoring Blood Pressure Matters
Because high blood pressure rarely causes symptoms, regular monitoring is crucial. Home blood pressure monitoring, often provides a more accurate picture than occasional readings taken in clinic alone. It also helps guide treatment decisions and track progress over time. Kinetik do blood pressure monitors you can see here, and you can record readings on ‘My Blood pressure’ where advice on reading levels will be provided.
High blood pressure is common, detectable and manageable. Understanding the stages of hypertension allows patients and clinicians to intervene early, reduce long-term risk and protect heart and brain health. Regular monitoring, healthy lifestyle choices and appropriate treatment remain the foundations of effective blood pressure management.
