Editing Blood pressure (section)

===Systemic arterial pressure===
Blood pressure measurements can be influenced by circumstances of measurement.<ref name=ESC2024/> Guidelines use different thresholds for office (also known as clinic), home (when the person measures their own blood pressure at home), and [[ambulatory blood pressure]] (using an automated device over a 24-hour period).<ref name=ESC2024/>
{| class="wikitable"
|+ Blood pressure classifications
|-
! Categories
! colspan="3" | Systolic blood pressure, [[mmHg]]
! rowspan=2 | and/or
! colspan="3" | Diastolic blood pressure, mmHg
|-
! Method
! Office
! Home
! 24h [[Ambulatory blood pressure|ambulatory]]
! Office
! Home
! 24h ambulatory
|-
! colspan="8" | [[American College of Cardiology]]/[[American Heart Association]] (2017)<ref name=Whelton2022>{{Cite journal |last1=Whelton |first1=Paul K |last2=Carey |first2=Robert M |last3=Mancia |first3=Giuseppe |last4=Kreutz |first4=Reinhold |last5=Bundy |first5=Joshua D |last6=Williams |first6=Bryan |date=2022-09-14 |title=Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines |url=https://academic.oup.com/eurheartj/article/43/35/3302/6661233 |journal=European Heart Journal |language=en |volume=43 |issue=35 |pages=3302–3311 |doi=10.1093/eurheartj/ehac432 |issn=0195-668X |pmc=9470378 |pmid=36100239}}</ref>
|-
| Normal
| <120
| <120
| <115
| and
| <80
| <80
| <75
|-
| Elevated
| 120–129
| 120–129
| 115–124
| and
| <80
| <80
| <75
|-
| Hypertension, stage 1
| 130–139
| 130–134
| 125–129
| or
| 80–89
| 80–84
| 75–79
|-
| Hypertension, stage 2
| ≥140
| ≥135
| ≥130
| or
| ≥90
| ≥85
| ≥80
|-
! colspan="8" | [[European Society of Cardiology]] (2024)<ref name=ESC2024>{{Cite journal |last1=McEvoy |first1=John William |last2=McCarthy |first2=Cian P |last3=Bruno |first3=Rosa Maria |last4=Brouwers |first4=Sofie |last5=Canavan |first5=Michelle D |last6=Ceconi |first6=Claudio |last7=Christodorescu |first7=Ruxandra Maria |last8=Daskalopoulou |first8=Stella S |last9=Ferro |first9=Charles J |last10=Gerdts |first10=Eva |last11=Hanssen |first11=Henner |last12=Harris |first12=Julie |last13=Lauder |first13=Lucas |last14=McManus |first14=Richard J |last15=Molloy |first15=Gerard J |display-authors=5 |date=2024-08-30 |title=2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO) |journal=European Heart Journal |volume=45 |issue=38 |pages=3912–4018 |language=en |doi=10.1093/eurheartj/ehae178 |doi-access=free |pmid=39210715 |issn=0195-668X}}</ref>
|-
| Non-elevated
| <120
| <120
| <115
| and
| <70
| <70
| <65
|-
| Elevated
| 120–139
| 120–134
| 115–129
| and
| 70–89
| 70–84
| 65–79
|-
| Hypertension
| ≥140
| ≥135
| ≥130
| or
| ≥90
| ≥85
| ≥80
|-
! colspan="8" | [[European Society of Hypertension]]/[[International Society of Hypertension]] (2023)<ref name=ESH2023>{{Cite journal |last1=Mancia |first1=Giuseppe |last2=Kreutz |first2=Reinhold |last3=Brunström |first3=Mattias |last4=Burnier |first4=Michel |last5=Grassi |first5=Guido |last6=Januszewicz |first6=Andrzej |last7=Muiesan |first7=Maria Lorenza |last8=Tsioufis |first8=Konstantinos |last9=Agabiti-Rosei |first9=Enrico |last10=Algharably |first10=Engi Abd Elhady |last11=Azizi |first11=Michel |last12=Benetos |first12=Athanase |last13=Borghi |first13=Claudio |last14=Hitij |first14=Jana Brguljan |last15=Cifkova |first15=Renata |display-authors = 5 |date=2023-12-01 |title=2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA) |journal=Journal of Hypertension |volume=41 |issue=12 |pages=1874–2071 |doi=10.1097/HJH.0000000000003480 |issn=1473-5598 |pmid=37345492|doi-access=free |hdl=11379/603005 |hdl-access=free }}</ref>
|-
| Optimal
| <120
| {{N/A}}
| {{N/A}}
| and
| <80
| {{N/A}}
| {{N/A}}
|-
| Normal
| 120–129
| {{N/A}}
| {{N/A}}
| and/or
| 80–84
| {{N/A}}
| {{N/A}}
|-
| High normal
| 130–139
| {{N/A}}
| {{N/A}}
| and/or
| 85–89
| {{N/A}}
| {{N/A}}
|-
| Hypertension, grade 1
| 140–159
| ≥135
| ≥130
| and/or
| 90–99
| ≥85
| ≥80
|-
| Hypertension, grade 2
| 160–179
| {{N/A}}
| {{N/A}}
| and/or
| 100–109
| {{N/A}}
| {{N/A}}
|-
| Hypertension, grade 3
| ≥180
| {{N/A}}
| {{N/A}}
| and/or
| ≥110
| {{N/A}}
| {{N/A}}
|}

The risk of cardiovascular disease increases progressively above 90&nbsp;mmHg, especially among women.<ref name=ESC2024/>

Observational studies demonstrate that people who maintain arterial pressures at the low end of these pressure ranges have much better long-term cardiovascular health. There is an ongoing medical debate over what is the optimal level of blood pressure to target when using drugs to lower blood pressure with hypertension, particularly in older people.<ref>{{cite journal | vauthors = Yusuf S, Lonn E | title = The SPRINT and the HOPE-3 Trial in the Context of Other Blood Pressure-Lowering Trials | journal = JAMA Cardiology | volume = 1 | issue = 8 | pages = 857–858 | date = November 2016 | pmid = 27602555 | doi = 10.1001/jamacardio.2016.2169 }}</ref>

Blood pressure fluctuates from minute to minute and normally shows a circadian rhythm over a 24-hour period,<ref>{{cite journal | vauthors = Smolensky MH, Hermida RC, Portaluppi F | title = Circadian mechanisms of 24-hour blood pressure regulation and patterning | journal = Sleep Medicine Reviews | volume = 33 | pages = 4–16 | date = June 2017 | pmid = 27076261 | doi = 10.1016/j.smrv.2016.02.003 }}</ref> with highest readings in the early morning and evenings and lowest readings at night.<ref>{{cite journal | vauthors = van Berge-Landry HM, Bovbjerg DH, James GD | title = Relationship between waking-sleep blood pressure and catecholamine changes in African-American and European-American women | journal = Blood Pressure Monitoring | volume = 13 | issue = 5 | pages = 257–262 | date = October 2008 | pmid = 18799950 | pmc = 2655229 | doi = 10.1097/MBP.0b013e3283078f45 | quote = Table2: Comparison of ambulatory blood pressures and urinary norepinephrine and epinephrine excretion measured at work, home, and during sleep between European–American (n = 110) and African–American (n = 51) women }}</ref><ref>{{cite journal | vauthors = van Berge-Landry HM, Bovbjerg DH, James GD | title = Relationship between waking-sleep blood pressure and catecholamine changes in African-American and European-American women | journal = Blood Pressure Monitoring | volume = 13 | issue = 5 | pages = 257–262 | date = October 2008 | pmid = 18799950 | pmc = 2655229 | doi = 10.1097/MBP.0b013e3283078f45 | id = NIHMS90092 }}</ref> Loss of the normal fall in blood pressure at night is associated with a greater future risk of cardiovascular disease and there is evidence that night-time blood pressure is a stronger predictor of cardiovascular events than day-time blood pressure.<ref name="HansenLi2010">{{cite journal | vauthors = Hansen TW, Li Y, Boggia J, Thijs L, Richart T, Staessen JA | title = Predictive role of the nighttime blood pressure | journal = Hypertension | volume = 57 | issue = 1 | pages = 3–10 | date = January 2011 | pmid = 21079049 | doi = 10.1161/HYPERTENSIONAHA.109.133900 | doi-access = free }}</ref> Blood pressure varies over longer time periods (months to years) and this variability predicts adverse outcomes.<ref>{{cite journal | vauthors = Rothwell PM | title = Does blood pressure variability modulate cardiovascular risk? | journal = Current Hypertension Reports | volume = 13 | issue = 3 | pages = 177–186 | date = June 2011 | pmid = 21465141 | doi = 10.1007/s11906-011-0201-3 | s2cid = 207331784 }}</ref> Blood pressure also changes in response to temperature, noise, emotional [[stress (medicine)|stress]], consumption of food or liquid, dietary factors, physical activity, changes in posture (such as [[orthostatic hypotension|standing-up]]), [[medication|drugs]], and disease.<ref>{{Cite book|title=Temporal Variations of the Cardiovascular System|date=1992|publisher=Springer Berlin Heidelberg | veditors = Engel BT, Blümchen G |isbn=978-3-662-02748-6 |location=Berlin, Heidelberg|oclc=851391490}}</ref> The variability in blood pressure and the better predictive value of ambulatory blood pressure measurements has led some authorities, such as the National Institute for Health and Care Excellence (NICE) in the UK, to advocate for the use of ambulatory blood pressure as the preferred method for diagnosis of hypertension.<ref>{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK83274/|title=Hypertension: The Clinical Management of Primary Hypertension in Adults: Update of Clinical Guidelines 18 and 34|last=National Clinical Guideline Centre (UK)|date=2011|publisher=Royal College of Physicians (UK)|series=National Institute for Health and Clinical Excellence: Guidance|location=London|pmid=22855971|access-date=2019-01-28|archive-date=2022-08-12|archive-url=https://web.archive.org/web/20220812074204/https://www.ncbi.nlm.nih.gov/books/NBK83274/|url-status=live}}</ref>
[[File:Blutdruck.jpg|thumb|A digital [[sphygmomanometer]] used for measuring blood pressure]]
Various other factors, such as age and [[sex]], also influence a person's blood pressure. Differences between left-arm and right-arm blood pressure measurements tend to be small. However, occasionally there is a consistent difference greater than 10&nbsp;mmHg which may need further investigation, e.g. for [[Peripheral artery disease|peripheral arterial disease]], [[Cardiovascular disease|obstructive arterial disease]] or [[aortic dissection]].<ref>{{cite journal | vauthors = Eguchi K, Yacoub M, Jhalani J, Gerin W, Schwartz JE, Pickering TG | title = Consistency of blood pressure differences between the left and right arms | journal = Archives of Internal Medicine | volume = 167 | issue = 4 | pages = 388–393 | date = February 2007 | pmid = 17325301 | doi = 10.1001/archinte.167.4.388 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Agarwal R, Bunaye Z, Bekele DM | title = Prognostic significance of between-arm blood pressure differences | journal = Hypertension | volume = 51 | issue = 3 | pages = 657–662 | date = March 2008 | pmid = 18212263 | doi = 10.1161/HYPERTENSIONAHA.107.104943 | s2cid = 1101762 | citeseerx = 10.1.1.540.5836 }}</ref><ref>{{cite journal | vauthors = Clark CE, Campbell JL, Evans PH, Millward A | title = Prevalence and clinical implications of the inter-arm blood pressure difference: A systematic review | journal = Journal of Human Hypertension | volume = 20 | issue = 12 | pages = 923–931 | date = December 2006 | pmid = 17036043 | doi = 10.1038/sj.jhh.1002093 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Clark CE, Warren FC, Boddy K, McDonagh ST, Moore SF, Goddard J, Reed N, Turner M, Alzamora MT, Ramos Blanes R, Chuang SY, Criqui M, Dahl M, Engström G, Erbel R, Espeland M, Ferrucci L, Guerchet M, Hattersley A, Lahoz C, McClelland RL, McDermott MM, Price J, Stoffers HE, Wang JG, Westerink J, White J, Cloutier L, Taylor RS, Shore AC, McManus RJ, Aboyans V, Campbell JL | display-authors = 6 | title = Associations Between Systolic Interarm Differences in Blood Pressure and Cardiovascular Disease Outcomes and Mortality: Individual Participant Data Meta-Analysis, Development and Validation of a Prognostic Algorithm: The INTERPRESS-IPD Collaboration | journal = Hypertension | volume = 77 | issue = 2 | pages = 650–661 | date = February 2021 | pmid = 33342236 | pmc = 7803446 | doi = 10.1161/HYPERTENSIONAHA.120.15997 | doi-access = free }}</ref>

There is no accepted diagnostic standard for hypotension, although pressures less than 90/60 are commonly regarded as hypotensive.<ref>{{cite book|chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK499961/|chapter=Hypotension|vauthors=Sharma S, Bhattacharya PT|date=2018|title=StatPearls|publisher=StatPearls Publishing|pmid=29763136|name-list-style=vanc|access-date=2018-12-23|archive-date=2020-03-17|archive-url=https://web.archive.org/web/20200317233648/https://www.ncbi.nlm.nih.gov/books/NBK499961/|url-status=live}}</ref> In practice blood pressure is considered too low only if [[Hypotension#Signs and symptoms|symptoms]] are present.<ref name="Mayo2009causes">{{cite web|url=http://www.mayoclinic.com/health/low-blood-pressure/DS00590/DSECTION=causes|title=Low blood pressure (hypotension) – Causes|author=Mayo Clinic staff|date=2009-05-23|website=MayoClinic.com|publisher=Mayo Foundation for Medical Education and Research|access-date=2010-10-19|archive-date=2021-11-17|archive-url=https://web.archive.org/web/20211117175541/https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/symptoms-causes/syc-20355465|url-status=live}}</ref>