Understanding your blood pressure (BP) is one of the most effective ways to monitor your long-term cardiovascular health.
However, the term “normal” is often misunderstood. Blood pressure is not a static number; it is a dynamic measurement that shifts based on your activity, your age, and your biological sex.
This guide explores how these variables influence your readings and what targets you should actually be aiming for.
Blood pressure is the force of your blood pushing against the walls of your arteries. Each reading provides two numbers:
Systolic (Top number): The pressure in your arteries when your heart beats.
Diastolic (Bottom number): The pressure in your arteries when your heart rests between beats.
As we age, our arteries naturally lose some of their elasticity and become stiffer. This process, known as atherosclerosis, typically causes blood pressure to rise over time.
Because the heart has to work harder to pump blood through these stiffer “pipes,” the numbers on the monitor climb as the decades pass.
Research consistently shows that age and gender play a significant role in determining what a “healthy” reading looks like for an individual.
1. Gender Differences
For much of early and middle adulthood, men typically exhibit higher blood pressure than women. This is largely attributed to hormonal differences and the protective effects of oestrogen in women.
However, this gap closes rapidly during menopause. As estrogen levels drop, women’s blood pressure often rises to meet—and sometimes exceed—that of their male peers, along with a corresponding increase in the risk of heart disease.
2. The Aging Process
While 120/80 mmHg is often touted as the “gold standard,” clinical targets often shift for older populations.
Young Adults: Focus is on maintaining low baseline pressure to prevent long-term arterial damage.
Over 75s: For the elderly, the goal may shift slightly. In some clinical guidelines, a target of under 150/90 mmHg is considered acceptable. This is because higher pressure is sometimes necessary to ensure an adequate blood supply reaches the brain through narrowed or stiffened vessels.
Note. In people over 75 yeras, targeting 120/80 is a mistake. If you run the BP this low, they are often in danger of falls (that can lead to fractures and hospital admission).
3. Pulse Pressure Expansion
Pulse pressure is the difference between your systolic and diastolic numbers (e.g. in a 120/80 reading, the pulse pressure is 40).
This gap typically widens with age. Hence, for example, a 20-year-old may have a pulse pressure of 40 mmHg, whereas an 80-year-old may have a pulse pressure of 70 mmHg due to the stiffening of the aorta.
While individual targets vary, the following table provides a general framework for adults. Note that these are “neat” categories used by clinicians to guide treatment but should be viewed as part of a larger health pattern.
| Category | Systolic (mmHg) | Diastolic (mmHg) | Clinical Action |
| Low (Hypotension) | < 90 | < 60 | Monitor for dizziness or fainting. |
| Optimal/Normal | 100–130 | 70–80 | Maintain current lifestyle. |
| High-Normal | 131–139 | 81–89 | Lifestyle modifications suggested. |
| High (Hypertension) | > 140 | > 90 | Medical intervention usually required. |
The “Hypertensive Crisis”
If you ever record a reading of 180/120 mmHg or higher, this is classified as a hypertensive crisis. This is a medical emergency that requires immediate attention to prevent a stroke or organ damage.
Uncontrolled high blood pressure (hypertension) is often called the “silent killer” because it frequently has no symptoms until significant damage has occurred. Persistently high readings increase the risk of:
Chronic Kidney Disease (CKD): High pressure damages the delicate filters in the kidneys.
Ischaemic Heart Disease (IHD): Increased strain leads to heart failure or heart attacks.
Stroke: Weakened blood vessels in the brain can burst or become blocked.
It is vital to remember that blood pressure fluctuates minute-to-minute. It follows a circadian rhythm (usually lower at night and higher in the morning) and can be spiked by stress, caffeine, or “white coat syndrome” at the doctor’s office.
Never rely on a single reading to diagnose hypertension. Doctors look for a consistent pattern of high readings over weeks or months before making a diagnosis or starting medication.
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