133/67 blood pressure is classed as a ‘High Normal (prehypertension)’ reading in the UK, ‘High Normal’ in the EU, ‘Elevated’ in Japan and ‘Hypertension Stage 1’ by US standards.
What 133 over 67 blood pressure means:
A BP reading of 133 over 67 means your blood pressure is classed as somewhere between ‘high 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 133 mmHg and a resting, diastolic pressure (when the heart is dilated or relaxing between beats) reading of 67 mmHg. They are both measured using units of mmHg, which stands for millimetres of mercury (read why here).
You may find it written as blood pressure 133 over 67, or more simply BP 133/67
| Reads | Systolic | Diastolic |
|---|---|---|
| 133-over-67 | 133 | 67 |
Looking at your systolic and diastolic numbers independently, means they would each fall into the following categories:
- A systolic reading of 133 is generally considered to be at the ‘prehypertension’ level.
- A diastolic reading of 67 is generally considered to be at the ‘ideal’ level.
Both your systolic and diastolic readouts are important to analyse, typically the one falling into a less healthy category determines your overall blood pressure condition. Therefore your overall blood pressure would be classified as prehypertension, moving above the normal blood pressure range, as your systolic reading is less healthy when comparing it with your diastolic reading.
You can see your blood pressure reading of 133 over 67 plotted on the chart above, noting that your overall classification for this BP reading falls into the prehypertension 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 that a single blood pressure reading is not definitive and it can be affected by a variety of factors.
If you regularly take your blood pressure readings at home with one of the modern blood pressure monitors (also called sphygmomanometers), you will have a more accurate average to work with. This is because you will be taking more readings throughout different times of the day than what you would get from a single visit to your medical clinic. You can then use this information to see if your blood pressure is ok, or if you need to make some healthy changes to your lifestyle to work towards having lower blood pressure.The column chart of your blood pressure shown above, displays the status of your systolic reading (higher blood pressure number) of 133mmHg compared to your diastolic reading (lower blood pressure number) of 67mmHg. Using these two blood pressure figures, you can go on to work out your blood pulse pressure.
What Is Blood Pulse Pressure?
The difference in value between your systolic and diastolic readings, which are shown on the blood pressure chart above, is known as pulse pressure. Your pulse pressure is therefore 66mmHg, calculated by subtracting your diastolic reading of 67mmHg from the systolic reading of 133mmHg.A normal pulse pressure is typically considered to be around 40mmHg. Your pulse pressure will vary naturally with different blood pressure readings but the variation will typically be in the 5 to 10 mmHg range. As always, it is best to take several readings to determine a true representative 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 66mmHg as a percentage of your systolic reading of 133mmHg comes in at 50%.
Narrow pulse pressure is a sign that the heart is not pumping a large enough volume of blood through it. This condition can present itself in situations where people are developing heart valve diseases or heart failure, or in cases of internal bleeding or resulting from significant blood loss due to 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 133/67 Differently
Your 133/67 reading is seen an high normal blood pressure often known as prehypertension 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. In the US your reading of 133/67 is indeed classed as Hypertension Stage 1.
Where Does My Blood Pressure Show 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 re-classified “prehypertension” as “elevated” blood pressure (120-129/<80 mmHg).
Your blood pressure readings on the ACC/AHA scale are shown below:
Above, you can see your blood pressure readings represented, here they have been plotted on the ACC/AHA hypertension chart which gives an overall status of hypertension stage 1.
The column chart above again compares your systolic (higher blood pressure number) reading of 133 to the diastolic (lower blood pressure number) reading of 67 and the status they have when considered individually. However this time it is using the ACC/AHA scale classiciation, which gives you a systolic status of hypertension stage 1 and a diastolic status of normal.
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
| 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
| 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
| 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
| 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
| 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 or 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 that my blood pressure readings are being classed as ‘prehypertension’ or ‘hypertension stage 1’?
Your blood pressure’s overall status comes in as ‘prehypertension’ 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 habits to reduce it back down to a lower blood pressure range. It is unlikely that you would recognise any high blood pressure symptoms yet, (one reason it is known as the “silent killer”) as hypertension symptoms only tend to be noticed at extremely high blood pressures.
There are several recommended lifestyle changes you might make alongside seeking any further recommendations from your healthcare professionals, for example:
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. It is estimated that obesity accounts for 65–78% of cases of primary hypertension.
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, reducing your chances of getting obesity related hypertension. 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, although 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 dietry 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 also be used to help achieve lower blood pressure as part of healthy lifestyle changes.
Do Regular Exercise and Concentrate on Ways to Reduce Stress
If you want to achieve lower blood pressure, you should exercise for 30 minutes or more every day. This could really be anything, like fast walking, jogging, swimming, playing football, or any other active sport. It is also important to try to reduce some of the stress in your life. You can potentially do this by trying to avoid situations which might stress you out, or by changing the way you deal with stressful situations. Some people find that meditation and taking time for their hobbies and interests can help reduce stress. 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 a reason to exercise every day.
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.Key Takeaways:
- Blood Pressure Classification: A blood pressure reading of 133/67 is classified differently across countries:
- UK: High Normal (prehypertension)
- EU: High Normal
- Japan: Elevated
- US: Hypertension Stage 1
- Understanding the Reading:
- Systolic Pressure (when the heart contracts): 133 mmHg
- Diastolic Pressure (when the heart relaxes): 67 mmHg
- Systolic reading of 133 is at the ‘prehypertension’ level, while a diastolic reading of 67 is at the ‘ideal’ level. The overall blood pressure is classified as prehypertension.
- Blood Pulse Pressure:
- Pulse pressure is the difference between systolic and diastolic readings. For a reading of 133/67, the pulse pressure is 66mmHg which is 50% of your systolic.
- A normal pulse pressure is around 40mmHg with a healthy percentage between 25-100%.
- Pulse pressure can indicate heart health, with narrow pulse pressure suggesting potential heart issues and wide pulse pressure indicating potential risks like stroke or heart disease.
- Interpretations Across Countries: Different countries have varying interpretations and classifications for the same blood pressure reading. For instance, the US classifies 133/67 as hypertension stage 1, while many other countries consider it prehypertension.
- Normal Blood Pressure Range: Ideally, blood pressure should be between 90/60mmHG and 120/80mmHg. High blood pressure, or hypertension, is often called the “silent killer” because it rarely shows symptoms.
- Concerns and Recommendations:
- A reading of 133/67 is a warning sign of potential hypertension in the future.
- Lifestyle changes are recommended to bring the blood pressure back to a normal range. These include maintaining a healthy weight, eating a balanced diet, exercising regularly, managing stress, quitting smoking, and moderating alcohol intake.
- DASH Diet: The Dietary Approaches to Stop Hypertension (DASH) diet can help in achieving lower blood pressure.