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90/81 Blood Pressure: Normal or Hypertension?

90/81 blood pressure is a ‘Normal’ blood pressure reading by EU standards, ‘Elevated’ in Japan, ‘High Normal’ in the UK and ‘Hypertension Stage 1’ in the US.

What does 90/81 blood pressure mean?

What 90 over 81 Blood Pressure Means:

A BP reading of 90 over 81 means your blood pressure is classed as somewhere between ‘normal’ to ‘Hypertension Stage 1’ depending on which country’s scale you look at; a systolic pressure (when the heart contracts on a beat) reading of 90 mmHg and a resting, diastolic pressure (when the heart is dilated or relaxing between beats) reading of 81 mmHg. Blood pressure numbers are presented in units of mmHg, which stands for millimetres of mercury (discover why here).

You may find your blood pressure readings written as blood pressure 90 over 81, or more simply BP 90/81

Reads Systolic Diastolic
90-over-81 90 81

Looking at your systolic and diastolic numbers independently, means they would each fall into the following categories:
  • A systolic reading of 90 is generally considered to be at the ‘low’ level.
  • A diastolic reading of 81 is generally considered to be at the ‘elevated normal’ level.

Both your systolic and diastolic readings play an important role when assessing your health. Typically, the reading that falls into a less favourable range dictates your overall blood pressure’s categorisation. In your case your overall blood pressure would be considered at the elevated normal level, towards the upper levels of the normal blood pressure range, as your systolic reading is healthier when comparing it to your diastolic reading.

You can see your blood pressure reading of 90 over 81 plotted on the chart above, noting that your overall classification for this BP reading falls into the elevated normal 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 at this point that a single blood pressure reading is not definitive as it can be affected by a variety of factors.

By taking your own blood pressure readings regularly at home, with one of the many affordable blood pressure monitors (also known as a blood pressure gauges or sphygmomanometers), you will get a more consistent average to work with, rather than the occasional reading given to you when visiting your doctor. You can then better understand if your blood pressure is ok and within the normal blood pressure range, or whether you may need to make some changes to your lifestyle to create lower blood pressure.

The column chart of your blood pressure above, compares the status of your systolic reading (higher blood pressure number) of 90mmHg to your diastolic reading (lower blood pressure number) of 81mmHg. It is from these two blood pressure elements that you can work out your blood pulse pressure.

What Is Blood Pulse Pressure?

Blood pulse pressure is the difference in value between your systolic and diastolic readings. Your pulse pressure is therefore 9mmHg, calculated by subtracting your diastolic reading of 81mmHg from the systolic reading of 90mmHg.

A normal pulse pressure is typically considered to be around 40mmHg. Your pulse pressure will naturally vary with different BP readings but the variation will typically be in the 5 to 10 mmHg range. Once again it is best to take several readings to determine an 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 9mmHg as a percentage of your systolic reading of 90mmHg comes in at 10%.

Narrow pulse pressure means the heart is not pumping a satisfactory amount of blood through with each beat. This is often seen in people who have might have issues such as heart valve disease or heart failure. It can also understandably be found in people who have lost a lot of blood from an injury.

Wide pulse pressure on the other hand, also referred to as high pulse pressure, can occur during exercise and is often seen in endurance athletes and high muscle-mass individuals without much concern. However, for less active and aging individuals experiencing hardening of the arteries, a wide pulse pressure occurs for different reasons and it 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 90/81 Differently

Your 90/81 reading is seen an elevated blood pressure in many countries, although the specific boundaries for each category and the naming of them can vary slightly between nations.

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.

You can check several country specific and international associations’ hypertension tables further down this page.

Where Is My Blood Pressure On The American College of Cardiology and American Heart Association (ACC-AHA) Hypertension Blood Pressure Chart?

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 removed the term “prehypertension” and re-classified it as “elevated” blood pressure (120-129/<80 mmHg).

Your blood pressure readings on the ACC/AHA scale are shown below:

You can see your blood pressure readings represented above, this time plotted on the ACC/AHA hypertension chart giving an overall status of hypertension stage 1.

The column chart above again shows your systolic (higher) number of 90 compared to the diastolic (lower) number of 81 and the status they each have when considered separately but this time on the ACC/AHA hypertension scale. Their reference scale gives you a systolic status of low and a diastolic status of hypertension stage 1.

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

Since 2023: source
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

Since 2017: source
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

Since 2019: source
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

Since 2023: source
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

Since 2020: source
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, known as 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 develop hypertension, reducing it to a lower blood pressure, even by only a small amount can help reduce your risk of developing these life threatening health conditions.

Should I be concerned about my ‘elevated normal’ or ‘hypertension stage 1’ blood pressure numbers?

Your blood pressure’s overall status comes in as ‘elevated normal’ in general, for example the World Health Organisation (WHO) would not currently regard it as being actual hypertension yet, but on the ACC/AHA (American College of Cardiology/American Heart Association) scale, which was revised in 2017 it would already be classified as being within their hypertension stage 1 range.

Either way it is a warning sign that you could be on your way to developing long-term high blood pressure (hypertension) problems and you should take steps to alter your lifestyle in order to bring it back down to a lower blood pressure range. It is unlikely that you would recognise any high blood pressure symptoms yet, as they only tend to manifest themselves at extremely high blood pressures.

There are several recommended lifestyle changes you might make alongside seeking any further recommendations from your healthcare professional, for example:

Quit Smoking/Vaping and Reduce The Amount Of Alcohol You Drink

Smoking (and vaping) or drinking too much alcohol can cause both short and long term increases in your blood pressure. While drinking low levels of alcohol has been shown to reduce blood pressure in some studies, exceeding moderate recommended intake levels can lead to alcohol induced hypertension – which has been shown to affect about 16% of the US population in past studies.

Keep Your Weight Under Control

Increased weight is normally associated with increased blood pressure. Losing a kilogram or 2.2 pounds will generally reduce you blood pressure reading by 1mm of mercury (mmHg). Women should look to keep waist sizes under 89cm or 35 inches and men less than 89cm or 40 inches (depending on ethnic group). Carrying too much weight around the waist increases the risk of high blood pressure.

Eat A Healthy Diet

Sticking to a diet rich in vegetables, fruit, nuts, and whole grains, together with low fat dairy products, will help you reduce saturated fat intake levels. It is also important to limit the amount of salt you eat, as salt intake has a direct correlation with higher blood pressure. However, as with caffeine, which may also elevate blood pressure after consumption, by about 10 mmHg, sensitivity varies from person to person. Eating foods high in potassium helps reduce the effects of sodium on blood pressure. According to the AHA most adults should aim to limit their sodium intake to around 1.5 grams a day (a teaspoon has about 2.5g), while the World Health Organisation (WHO) deems the average actual consumption is closer to 9-12 grams per day. Opt for low sodium varieties of any processed food you buy, as processed food is typically high in salt content and accounts for 80% of the dietary salt intake in most countries according to the WHO. So remember to analyse food labels to see how your sodium intake might be adding up. Diet plans referred to as, ‘DASH diets’ (Dietary Approaches to Stop Hypertension) can be used to help achieve lower blood pressure as part of healthy lifestyle changes.

Exercise and Find Ways to Reduce Stress

Consistent regular exercise of 30 minutes a day or more will help you on your way to lower blood pressure, whether that’s fast walking, jogging, swimming, weight training or any active sports activity, they can all be beneficial. Also look to find ways to reduce the stress in your life wherever possible, try to avoid stress triggers or make alterations to the way you handle stressful situations, by trying to do so in a calm and controlled manner. Some people find meditation, hypnosis or just setting aside time to explore their interests and hobbies can help to reduce stress. Doing so will be beneficial to keeping blood pressure in a healthy range. Dogs have also been found to be beneficial in reducing stress and lowering blood pressure in humans and aside from the interaction with them, they provide an excellent reason to exercise every day.

Key Takeaways: 90/81 Blood Pressure

  1. Classification by Region:
    • EU: Normal
    • Japan: Elevated
    • UK: High Normal
    • US: Hypertension Stage 1
  2. Understanding the Reading:
    • A blood pressure reading of 90/81 is interpreted differently across countries, ranging from ‘normal’ to ‘Hypertension Stage 1’.
    • The systolic pressure (when the heart contracts) is 90 mmHg, and the diastolic pressure (when the heart relaxes) is 81 mmHg.
    • Both systolic and diastolic readings are crucial for health assessment. The less favorable of the two typically determines the overall blood pressure classification.
  3. Blood Pulse Pressure:
    • Blood pulse pressure is the difference between systolic and diastolic readings. For a reading of 90/81, the pulse pressure is 9mmHg.
    • A normal pulse pressure is around 40mmHg. A pulse pressure below 25% of the systolic reading is concerning, while over 100% indicates potential risks. Yours comes in at 10%.
  4. Interpretation Across Countries:
    • Different countries have varying scales and boundaries for blood pressure categories. For instance, the US revised its scale in 2017, lowering the hypertension threshold, while the EU maintained its previous boundary in 2018.
  5. General Blood Pressure Information:
    • A normal blood pressure range is between 90/60mmHG and 120/80mmHg.
    • High blood pressure, or hypertension, is a silent killer with potential severe health risks, including heart disease, strokes, and kidney disease.
  6. Managing Blood Pressure:
    • Lifestyle changes, such as quitting smoking, reducing alcohol and stress, maintaining a healthy weight, eating a balanced diet, considering things like dairy, and regular exercise, can help manage and reduce blood pressure.
    • Monitoring blood pressure at home provides a more consistent average than occasional doctor visits.
  7. Recommendations:
    • Individuals with a reading of 90/81 should consider lifestyle modifications to prevent potential long-term hypertension issues. Regular monitoring and consultation with healthcare professionals are advised.

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