141/128 blood pressure is rated at the ‘Hypertensive Crisis’ level by US standards and is classed as a ‘Hypertension Stage 3’ blood pressure reading by the EU, UK and Japan, also known as ‘Severe Hypertension’
What 141 over 128 blood pressure means:
A BP reading of 141 over 128 means your blood pressure is classed at the Hypertensive Crisis level, or Stage 3 (severe) depending which nation’s scale you look at; a systolic pressure (when the heart contracts on a beat) reading of 141 mmHg and a resting, diastolic pressure (when the heart is dilated or relaxing between beats) reading of 128 mmHg. Blood pressure readings are presented in millimetres of mercury, the units being mmHg (discover why here).
You may find it written as blood pressure 141 over 128, or more simply BP 141/128
| Reads | Systolic | Diastolic |
|---|---|---|
| 141-over-128 | 141 | 128 |
Looking at your systolic and diastolic numbers independently, means they would each fall into the following categories:
- A systolic reading of 141 is generally considered to be at the ‘hypertension stage 1’ level.
- A diastolic reading of 128 is generally considered to be at the ‘severe hypertension’ level.
Between the two, the one falling into a less healthy range determines your blood pressure’s overall status. In your case, it is defined as severe hypertension, because your systolic reading is healthier when comparing it to the status of your diastolic reading.
You can see your blood pressure reading of 141 over 128 plotted on the chart above, noting that your overall classification for these BP readings falls into the severe hypertension range.
Minor variations exist in the naming conventions and specific boundaries of each category between different nations. We show what these differences are in the tables presented later in this article so you know where you stand on the EU, US, UK, Japan and International Society of Hypertension (ISH) scales and plot you on the United States’ blood pressure chart too. It is important to consider that a single blood pressure reading is not definitive and it can be affected by a number of factors.
By taking your own blood pressure readings at different times of the day, with one of the many readily available home blood pressure monitors (also known as a blood pressure gauges or sphygmomanometers), you will be able to get a representative average reading to work with, rather than the occasional reading given to you when visiting your doctor. Jumping to conclusions from a single reading is not advised and using the average, you can gain a much better understanding whether your blood pressure is ok and within the normal blood pressure range, or whether you may need to make some changes to your lifestyle or have your doctor decide if blood pressure medication is required to lower blood pressure.The column chart of your blood pressure is shown above and displays the status of your systolic reading (higher blood pressure number) of 141mmHg compared to your diastolic reading (lower blood pressure number) of 128mmHg. Using these two blood pressure figures, you can go on to establish what your blood pulse pressure is.
What Is Blood Pulse Pressure?
The difference in value between your systolic and diastolic readings, which are shown on the blood pressure chart above, is known as pulse pressure. Your pulse pressure is therefore 13mmHg, calculated by subtracting your diastolic reading of 128mmHg from the systolic reading of 141mmHg.A normal pulse pressure is typically considered to be around 40mmHg. Your pulse pressure will vary naturally with different blood pressure readings but the variation will typically be in the 5 to 10 mmHg range. As always, it is best to take a number of different readings to determine a truly representative average.
A pulse pressure which is less than 25% of your systolic pressure is considered concerningly low and over 100%, would be considered wide. Your pulse pressure of 13mmHg as a percentage of your systolic reading of 141mmHg comes in at 9%.
Having a small pulse pressure reading, variably known as a narrow pulse pressure or low pulse pressure, tends to mean that the heart is generally pumping a lower volume of blood through it when it beats than desired. It can occur in association with various conditions such as heart valve diseases or heart failure. It will also appear in cases of significant internal bleeding or blood loss from a physical injury.Wide pulse pressure on the other hand, which can also be referred to as high pulse pressure, can occur during exercise and is regularly seen in endurance athletes and high muscle-mass individuals without much concern. However, for less active and aging individuals that may be experiencing hardening of the arteries, a wide pulse pressure develops for different reasons and that can be a warning sign of increased risk of stroke, heart rhythm problems and heart disease.
If you are concerned about your pulse pressure, ask your healthcare professional for advice.
Different Countries May Interpret 141/128 Differently
Your 141/128 reading is seen as Hypertension Stage 3 in most countries, the specific boundaries for each category and the naming of them can vary slightly between nations such as stage/grade or at the upper levels, stage 3/severe/crisis etc.
Revisions to these scales also occur, notably in 2017, leading U.S. health groups, including the American College of Cardiology and the American Heart Association, set lower levels for what counts as the start of high blood pressure and removed the term prehypertension from their scale. Yet when the EU later reviewed their scale in 2018, they maintained a higher boundary for the start of hypertension. So, large segments of the US population defined as having high blood pressure would not be considered to be suffering from hypertension by the EU. The UK also used to consider a diastolic reading over 110 mmHg as severe but this boundary was later moved up to be greater than 120 mmHg.
Where Does My Blood Pressure Feature On The American College of Cardiology and American Heart Association (ACC-AHA) Hypertension Chart Scale?
The ACC/AHA hypertension scale was most recently revised in 2017 and the major change at that time was lowering the definition of the start of hypertension from ≥140/≥90 mmHg to ≥130/≥80 mmHg. It also re-classified “prehypertension” as “elevated” blood pressure (120-129/<80 mmHg).
Your blood pressure readings on the ACC/AHA scale are shown below:
On the chart above you can see your blood pressure reading, this time plotted on the ACC/AHA scale giving an overall BP classification of hypertensive crisis.
Seen above, the column chart compares your systolic (higher blood pressure number) reading of 141 to the diastolic (lower blood pressure number) reading of 128 and the status they have if considered one by one, but this time using the ACC/AHA hypertension scale which gives you a systolic status of hypertension stage 2 and a diastolic status of hypertensive crisis.
Categorisations of Blood Pressure by Region/Country
Here we present the latest revised blood pressure tables and naming terms used by the EU, US, Japan, UK and International Society of Hypertension (ISH). Some differentiate office vs home readings, office not meaning your workplace but the office of the medical staff. The reason this differentiation is made is because medical environments can be stressful and raise the readings compared to what is achieved when relaxing at home and taking your own measurements.
European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) Classifications
| Category | Systolic (mmHg) | Diastolic (mmHg) | |
|---|---|---|---|
| Optimal (Ideal) | <120 | and | <80 |
| Normal | 120–129 | and/or | 80–84 |
| High normal | 130–139 | and/or | 85–89 |
| Grade 1 hypertension | 140–159 | and/or | 90–99 |
| Grade 2 hypertension | 160–179 | and/or | 100–109 |
| Grade 3 hypertension | ≥180 | and/or | ≥110 |
| Isolated systolic hypertension | ≥140 | and | <90 |
| Isolated diastolic hypertension | <140 | and | ≥90 |
American College of Cardiology (ACC)/American Heart Association (AHA) Classifications
| Category | Systolic (mmHg) | Diastolic (mmHg) | |
|---|---|---|---|
| Normal | <120 | and | <80 |
| Elevated | 120-129 | and | <80 |
| Stage 1 | 130-139 | or | 80-89 |
| Stage 2 | ≥140 | or | ≥90 |
| Hypertensive crisis | >180 | and/or | >120 |
Japanese Society of Hypertension (JSH) Classifications
| Classification | Office blood pressure (mmHg) | Home blood pressure (mmHg) | ||
|---|---|---|---|---|
| SBP | DBP | SBP | DBP | |
| Normal blood pressure | <120 | and <80 | <115 | and <75 |
| High normal blood pressure | 120–129 | and <80 | 115–124 | and <75 |
| Elevated blood pressure | 130–139 | and/or 80–89 | 125–134 | and/or 75–84 |
| Grade I hypertension | 140–159 | and/or 90–99 | 135–144 | and/or 85–89 |
| Grade II hypertension | 160–179 | and/or 100–109 | 145–159 | and/or 90–99 |
| Grade III hypertension | ≥180 | and/or ≥110 | ≥160 | and/or ≥100 |
| (Isolated) systolic hypertension | ≥140 | and <90 | ≥135 | and <85 |
UK National Health Service (NHS)/British Heart Foundation(BHF) Classifications
| Classification | Office blood pressure (mmHg) | Home blood pressure (mmHg) | ||
|---|---|---|---|---|
| SBP | DBP | SBP | DBP | |
| Low blood pressure | <90 | <60 | <90 | <60 |
| Normal blood pressure (Under 80s) | 90–120 | 60–80 | 90–120 | 60–80 |
| Normal blood pressure (Over 80s) | <150 | <90 | <145 | <85 |
| High-normal blood pressure (pre-hypertension) | 120–140 | 80–90 | 120–140 | 80–90 |
| Stage one | 140–160 | 90–100 | 135–150 | 85–95 |
| Stage two | 160–180 | 100–120 | >150 | >95 |
| Stage three (Severe hypertension) | >180 | >120 | N/A | N/A |
International Society of Hypertension (ISH) Classification
| Category | Systolic (mm Hg) | Diastolic (mm Hg) | |
|---|---|---|---|
| Normal BP | <130 | and | <85 |
| High-normal BP | 130–139 | and/or | 85–89 |
| Grade 1 hypertension | 140–159 | and/or | 90–99 |
| Grade 2 hypertension | ≥160 | and/or | ≥100 |
What Is A Normal Blood Pressure Range?
Ideally your blood pressure should be between 90/60mmHG and 120/80mmHg to be considered within the normal blood pressure range, also known as the normotension range. The main concern however, often referred to as the “silent killer,” is high blood pressure or hypertension, which rarely has obvious symptoms. The World Health Organisation estimates 1.28 billion adults aged 30-79 have high blood pressure, with 46% of those unaware that they have it. If left untreated persistent hypertension can increase your risk of a number of serious and potentially life-threatening health conditions, such as:
-
– aortic aneurysms
– heart attacks
– heart disease
– heart failure
– kidney disease
– peripheral arterial disease
– strokes
– vascular dementia
If you have high blood pressure, reducing it even a small amount can help lower your risk of experiencing these potentially life threatening conditions.
Should I be concerned about my ‘severe hypertension’ or ‘hypertensive crisis’ blood pressure status?
Yes. Your blood pressure’s overall status comes in as being at the ‘severe hypertension’ level in general. On the ACC/AHA (American College of Cardiology/American Heart Association) scale it also rates at the similar ‘hypertensive crisis’ level. This is a very high blood pressure.
Your blood pressure is at a dangerously high level with increased risk of it resulting in a stroke and organ damage – medical attention should be sought immediately and your blood pressure readings confirmed. With blood pressures consistently around these levels, blood vessels become inflamed causing them damage, blood or fluid may be forced out from them impacting the efficiency with which the heart is able to pump blood around the body and can lead to potentially fatal consequences.
You may not notice any symptoms but those associated with severe hypertension/hypertensive crisis can include:
- Severe headaches
- Shortness of breath
- Seizures
- Dizziness
- Nausea
- Severe anxiety
- Unresponsiveness
- Chest pain
- Blurry vision
- Fluid on the lungs (pulmonary edema) or fluid build-up in tissues
Once blood pressure reaches these severe hypertension or hypertensive crisis levels you may or may not experience damage to your organs. If damage to your organs has or does occur then it becomes an emergency situation associated with life threatening complications. Treatments may include hospitalisation, intravenous and oral medications.
Causes of hypertensive emergency may include:
- Heart Attack
- Stroke
- Heart failure
- Kidney failure
- Rupture of the aorta artery (aneurysm)
- Incompatible medicine interactions
- Not taking prescribed blood pressure medication
- Heart failure
- Pregnancy eclampsia (convulsions)
Even without any organ damage occurring there is still great urgency to reduce your blood pressure if it is coming in around these hypertensive crisis levels, so you should seek to have accurate measurements of your blood pressure confirmed by health professionals straight away. Lifestyle changes to lower blood pressure become less effective at these sorts of severe hypertension levels, particularly with the urgency required to reduce it, so blood pressure medication and or hospital treatment will most likely be required to quickly bring the blood pressure down to a safer level.
Key Takeaways:
- Blood Pressure Classification: A reading of 141/128 is classified as:
- ‘Hypertensive Crisis’ by US standards.
- ‘Hypertension Stage 3’ or ‘Severe Hypertension’ by the EU, UK, and Japan.
- Understanding the Reading:
- Systolic Pressure (when the heart contracts): 141 mmHg
- Diastolic Pressure (when the heart relaxes): 128 mmHg
- Variations in Classification: Different countries and organizations have their own scales and definitions for hypertension. It is essential to be aware of these differences and understand where your blood pressure stands on various scales as they are modified over time.
- Blood Pulse Pressure:
- Pulse pressure is the difference between systolic and diastolic readings. For a reading of 141/128, the pulse pressure is 13mmHg. A typical pulse pressure is around 40mmHg.
- Your pulse pressure of 13mmHg as a percentage of your systolic reading of 141mmHg is 9%.
- A pulse pressure less than 25% of the systolic pressure is considered concerningly low, and over 100% would be considered wide.
- Immediate Medical Attention Needed:
- A blood pressure reading at this level indicates a critical risk. It is urgent to consult with a medical professional today if you are not already being treated for high blood pressure. Persistent readings at this level can lead to strokes, organ damage, and other life-threatening conditions.
- Symptoms associated with severe hypertension/hypertensive crisis can include severe headaches, shortness of breath, seizures, dizziness, nausea, severe anxiety, chest pain, blurry vision, and fluid on the lungs. If you are experiencing symptoms like these alongside severe BP readings, seek emergency medical attention right away.
As the ISH says, hypertension “is the leading cause of death worldwide, affecting more than 1.4 billion people and accounting for more than 28,000 deaths each day.”
