Normal blood pressure range
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Normal Blood Pressure Range: Definitions and Guidelines
The most widely accepted definition of normal blood pressure is less than 120/80 mmHg, according to the 2017 American College of Cardiology/American Heart Association guidelines. Blood pressure readings between 120–129 mmHg systolic and less than 80 mmHg diastolic are considered "elevated," while readings of 130–139 mmHg systolic or 80–89 mmHg diastolic are classified as stage 1 hypertension. This definition is supported by several recent clinical and epidemiological studies, which emphasize the importance of maintaining blood pressure below these thresholds to reduce cardiovascular risk467.
Ambulatory Blood Pressure: Mean Values and Normal Ranges
Ambulatory blood pressure monitoring, which measures blood pressure over 24 hours, provides additional insight into normal ranges. Meta-analyses show that the average 24-hour blood pressure in healthy adults is about 115–120/70–75 mmHg, with daytime averages of 120–125/75–80 mmHg and nighttime averages of 105–110/60–65 mmHg. The normal range for 24-hour ambulatory blood pressure is typically 97–139/57–87 mmHg. Some experts suggest that a 24-hour average below 125/80 mmHg is within the normotensive range.
Age, Individual Variation, and Historical Perspectives
Historically, the definition of normal blood pressure has changed, with older guidelines allowing higher values, especially in older adults. Earlier standards considered systolic pressures up to 140, 150, or even 160 mmHg as normal, particularly for those over 40 years old210. However, more recent evidence suggests that lower blood pressure is generally associated with better long-term cardiovascular health, though individual variation and age should still be considered67.
Cardiovascular Risk and Blood Pressure Within the Normal Range
Studies indicate that, in healthy individuals without cardiovascular risk factors, systolic blood pressure between 90 and 129 mmHg does not increase the risk of cardiovascular disease. The risk of cardiovascular events rises as blood pressure moves above this range, but within the normal range, there is no significant increase in risk. Maintaining blood pressure at the lower end of the normal range is associated with the best long-term outcomes67.
Clinical Implications and Risk Assessment
Switching the upper limit of normal systolic blood pressure from 140 mmHg to 130 mmHg improves risk assessment and better identifies individuals at increased risk of mortality, while still including a large portion of the population. Blood pressure variability, not just the average value, is also linked to cardiovascular risk, especially in younger individuals and those with lower baseline blood pressure.
Conclusion
Normal blood pressure is generally defined as less than 120/80 mmHg, with ambulatory averages supporting similar thresholds. While historical and age-related variations exist, current evidence supports maintaining blood pressure at the lower end of the normal range for optimal cardiovascular health. Individual factors and blood pressure variability should also be considered in clinical practice1346789.
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