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Changing Definitions of High Blood Pressure for the 2020s

Ms. Inglish has 30 years experience in medicine, psychology, STEM instruction, history, and aerospace education for USAF Civil Air Patrol.

Changes of Definitions and Effects of Aging

Some of us in health and medical professions have been frustrated by medical definition changes, especially the definition of high blood pressure (HBP) or hypertension.

No matter what the definition, many people have HBP without even knowing it. And many who do know do not comply with measures that can lower their blood pressure as well as the risks for heart attack and stroke (e.g., diet, exercise, stress management, stopping smoking, reducing alcohol intake, individual factors, and others).

To the health practitioner dealing with blood pressure and cardiovascular risk factors, the total blood system landscape makes a Gordian Knot.

U.S. Blood Pressure Guidelines Since 2010

National Heart Lung and Blood Institute Guidelines 2010. Data provided by the US National Institutes of Health, US Department of Health and Human Services.

Level Systolic Diastolic 

Average ("Normal") - BOTH numbers must fall into line 




120 - 139 

80 -89 

Stage 1 HBP (EITHER number)

140 - 149

90 - 99

Stage 2 HBP (EITHER number)



Examples of Hypertension Levels by New Guidelines

  • Normal: 119/79
  • Elevated: Systolic 120-129 and diastolic 79 or less
  • Stage 1 Hypertension: Systolic 130-139 or diastolic 80-89
  • Stage 2 Hypertension: Systolic 140+ or diastolic 90+
  • Hypertensive Crisis: Systolic 180+ and/or diastolic 120+

Frustrating Changes in HBP Definitions

After several years of quoting "120/80" as normal blood pressure and "140/90" as HBP, we were told by medical professors in the1990s that we were incorrect.

By 2003, new national guidelines in America were in place and were more clearly stated by the National Institutes of Health in 2010.

We began to be directed that:

  • 120/80 is the lower limit of pre-hypertension.
  • 119/79 is "high normal."

I felt thereafter that I had to be very careful about what I told clients and test participants so as not to be alarmist.

Many people have the condition (hypertension) without knowing they have it

Seek a Trusted Qualified Opinion for Heart Health

While some useful information exists here and in official website data from the National Institutes of Health, the American Heart Association, the Red Cross, and other organizations, I think it is important that you be working with a licensed healthcare or a well-trained and knowledgeable alternative health practitioner in order to determine the healthiest blood pressure levels for your individual Self.

The same may be stated for other vital signs and other biological/health readings. I can't point from the Internet and say "so-and-so has high blood pressure." However, some physicians are beginning to consult with some patients over the Internet. In the future, we can probably send many of our vital signs over the web.

NOTE: A single reading with a high number is not a final diagnosis of high blood pressure. Take more than one reading over time, compare them, and consult with your healthcare practitioner!

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Read More From Healthproadvice

To Infinity and Beyond With BP Rates

Critical Blood Pressure

Recommended definitions for HBP and hypertension may change again as humankind begins to explore deep space and live and work on the Moon and asteroids that we will mine for resources. This may occur before the year 2024, the year NASA was ordered by the Trump Administration to return to Luna.

One critical consideration is that there exists a condition known formally as Uncontrollable High Blood Pressure (HBP).

No medication, no technique, nothing works to lower and stabilize this blood pressure condition.

I listened as a group of Ohio physicians in the early 1990s discussed that they would like to construct a cardiovascular treatment clinic on the Moon for these cases, the reduced gravity believed to probably reduce blood pressure permanently. It is an interesting notion.

Medical lecturers I have heard stated in the late 1990s that perhaps the blood pressures of senior citizens increases with age overall as a natural process of aging.

Today, many articles submit that average blood pressure raises with age, but that the rising BP rates can be lowered with preventive measures, especially if taken up in earlier life. But how high is high?

Ohio physicians in the early 1990s discussed that they would like to construct a cardiovascular treatment clinic on the Moon.

NASA, 1982. "Self-growing lunar factory." Is a moon base the answer to uncontrollable hypertension?

NASA, 1982. "Self-growing lunar factory." Is a moon base the answer to uncontrollable hypertension?

How Blood Pressure Changes in Space

Even after studying and working with blood pressure risk prevention and treatment, I want to consider individual differences in people as well as national guidelines, so I advise people to ask their healthcare providers about their own readings and not to rely 100% on tables of guidelines. Guidelines do not represent individual differences.

Guidelines change, new information emerges every day, and we may not have immediate access to it all, even with the Internet running 24/7.

New journal articles are sometimes available only at a high fee, for example. I read regularly for new information and there, I learned that human blood pressure is generally higher in winter than summer - a seasonal difference. I did not learn that in my medical classes.

America is deeply into Mars exploration and colonization; privatized space flight is increasing and all of this may show that we need new guidelines for blood pressure that changes "out there."

Important Questions for the Future

  • How many G-forces can one tolerate and how does this tolerance change per every decade or year of aging? -- Senator John Glenn was able to fly into space and tolerate G-forces at the age of 77. His blood pressure did not present a problem.
  • Could an older person die on a roller coaster or a rocket launch because of blood pressure events? They probably could. Increasing G-forces occur on roller coasters as well, and coaster operators warn riders about high blood pressure.
  • People living in extraterrestrial colonies in a gravity less than Earth's will likely experience lower blood pressure. But then, how low is low? -- In space, calcium leeches out of bones and teeth, and muscles lose mass and tone, no matter how much exercise is done. Ongoing aerospace medical research is examining the unwanted decrease in eyesight (to the extent of becoming legally blind) and blood pressure changes at this time.

In the coming years, we may develop a set of blood pressure guidelines specifically for individuals who live and work in outer space, on the Moon, and on Mars. In fact, we may need three sets of guidelines for these three places.

First US Space Shuttle mission, STS-1, Space Shuttle Columbia; 1981. AStronauts experienced lowered blood pressure that caused lightheadedness.

First US Space Shuttle mission, STS-1, Space Shuttle Columbia; 1981. AStronauts experienced lowered blood pressure that caused lightheadedness.


This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2010 Patty Inglish MS


Patty Inglish MS (author) from USA and Asgardia, the First Space Nation on September 07, 2010:

David - I hope you are feelking well now; blood pressures can be extremely frustrating.

kaltopsyd - That had totally slipped my mind. I remember learning 4 different CPR methods for adults in about 20 years; so I am going to review my latest manuals today!

kaltopsyd from Trinidad originally, but now in the USA on September 07, 2010:

Thank you, Ms. Patty for an amazingly written article. I enjoyed reading it and learning something new as well. It's amazing how things change in the medical field - and quite often too. This change reminded me of how the method for CPR and other rescue techniques have changed in the last few years. Thanks for writing this article - so clear, organised and easy to read.

david stillwagon on September 05, 2010:

I have had problems with keeping my blood pressure "normal" for years. I find that if it gets too high I usually get a bad headache if too low then I get light headed.

Through the years I have had to adjust the meds I take. It can be quite a juggling act.

Terrific well thought out hub

Hello, hello, from London, UK on September 05, 2010:

You have raised a very important topic and included a lot of information which bound to help. These days with all the stress and pressure it is very important to keep an eye on blood pressure which can cause strokes and heartattacks unnecessarily. Thank you, Patty, for writing such an appreciated hub.

Tony from At the Gemba on September 04, 2010:

I hope I get to live on a colony on mars one day to check the effects of my blood pressure! Fine hub.

Lori J Latimer from Central Oregon on September 04, 2010:

Thank you for this important article. Each person is different, and I am glad that someone is taking notice of that. Great Hub.

Patty Inglish MS (author) from USA and Asgardia, the First Space Nation on September 04, 2010:

Jerilee - Thanks for reading and I send you and your husband best wishes for health and comfort. It can all be so frustrating and frightening. Your information sharing helps the rest of us as well and thanks for that. I know little about the irregular heart beat and this reminds me to read about it. Hugs to you!

Jerilee Wei from United States on September 04, 2010:

Because of my husband's ongoing heart issues I am required to take his blood pressure several times a day and report that back to telephone triage nurses. This article helped me to understand a little better what the numbers could mean. I have high blood pressure and take medication too, but only check my own occasionally as it stresses me to know too much sometimes. The blood pressure machines the VA provides us with also measure pulse and heart rhythm and it seems that when the blood pressure is up, is when he gets the irregular heart beat warnings.

Patty Inglish MS (author) from USA and Asgardia, the First Space Nation on September 04, 2010:

Thanks for the comments!

@DiamondRN - I know several people under treatment for both. Can be very serious.

@theindianblues - Glad you liked it!

@Georzetta - The American Heart Assn. advises only to ask one's doctor how often is best, but also that a professional should take the reading at least once every 2 years. I like to see trends, so I kept the habit since grad.

Just my opinion, but I tink people in high stress jobs working long hours may benefit from seeing their readings more often than once in 2 years.

Georzetta Ratcliffe from Pennsylvania on September 04, 2010:

Very interesting! Is there any information to indicate that monitoring your blood pressure several times a week is more valuable to your general health than tracking it every few months?

theindianblues from Some where on the Globe on September 04, 2010:

Good work Patty Inglish, MS; This is what I am looking for. Thanks for sharing such a wonderful and detailed hub.

Bob Diamond RPh from Charlotte, NC USA on September 04, 2010:

High blood pressure combined with high cholesterol is a recipe for strokes and heart attacks.

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