146/109 blood pressure is classed as a ‘Hypertension Stage 2’ blood pressure reading by the EU, Japan, UK, US and International Society of Hypertension (ISH) standards.
What 146 over 109 blood pressure means:
A BP reading of 146 over 109 means your blood pressure is classed as Hypertension Stage 2; a systolic pressure (when the heart contracts on a beat) reading of 146 mmHg and a resting, diastolic pressure (when the heart is dilated or relaxing between beats) reading of 109 mmHg. Blood pressure readings are presented in millimetres of mercury, the units being mmHg (you can find out why here).
You may find it written as blood pressure 146 over 109, or more simply BP 146/109
| Reads | Systolic | Diastolic |
|---|---|---|
| 146-over-109 | 146 | 109 |
Looking at your systolic and diastolic numbers independently, means they would each fall into the following categories:
- A systolic reading of 146 is generally considered to be at the ‘hypertension stage 1’ level.
- A diastolic reading of 109 is generally considered to be at the ‘hypertension stage 2’ level.
Both your systolic and diastolic blood pressure numbers are important to consider but generally the one falling into a less healthy classification determines your overall blood pressure condition. So in your case, your overall blood pressure status would be considered at the hypertension stage 2 level, a level of concern, as your systolic reading is healthier when comparing it to your diastolic reading.
You can see your blood pressure readings of 146 over 109 plotted on the chart above, noting that your overall classification for this BP reading falls into the hypertension stage 2 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 at the time of taking the reading.
If you regularly take your blood pressure readings at home with a blood pressure monitor (sphygmomanometer or blood pressure gauge), you will have a more consistent average to work with than if you only go to the doctor for the occasional reading. This way, you can better understand if your blood pressure is okay or whether you need to make some changes to your lifestyle or consult with your doctor about hypertension medicine in order to aim for a lower blood pressure.The column chart of your blood pressure displayed above, shows the status of your systolic reading (higher blood pressure number) of 146mmHg compared to your diastolic reading (lower blood pressure number) of 109mmHg. With these two blood pressure numbers you can work out what your pulse pressure is.
What Is Blood Pulse Pressure?
Blood pulse pressure is the difference in value between your systolic and diastolic readings. Your pulse pressure is therefore 37mmHg, calculated by subtracting your diastolic reading of 109mmHg from the systolic reading of 146mmHg.
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 a number of different readings to determine a truly 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 37mmHg as a percentage of your systolic reading of 146mmHg comes in at 25%.
Narrow or low pulse pressure generally shows that the heart is not pumping a satisfactory amount of blood through it when it beats. This is quite often seen in people who have might have issues such as heart valve disease or heart failure. It can also be the result of significant blood loss from an injury or internal bleeding.Wide pulse pressure on the other hand, which can also be referred to as high pulse pressure, can occur during exercise and is regularly seen in endurance athletes and high muscle-mass individuals without much concern. However, for less active and aging individuals that may be experiencing hardening of the arteries, a wide pulse pressure develops for different reasons and that 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 146/109 Differently
Your 146/109 reading is seen as Hypertension Stage 2 in most 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.
You can check several country specific and international associations’ hypertension tables further down this page.
Where On The American College of Cardiology (ACC) and American Heart Association (AHA) Hypertension Scale, Does My Blood Pressure Plot?
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:
On the blood pressure chart above you can see your blood pressure reading, this time plotted on the ACC/AHA hypertension chart scale, giving an overall status of hypertension stage 2.
The column chart above again compares your systolic (higher) reading of 146 to the diastolic (lower) reading of 109 and the status they have if considered individually but this time on the ACC/AHA scale definition giving a systolic status of hypertension stage 2 and a diastolic status of hypertension stage 2.
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 have high blood pressure, reducing it even a small amount can help lower your risk of experiencing these serious health conditions.
Should I Be Concerned About My Hypertension Stage 2 Blood Pressure Status?
Your blood pressure’s overall status comes in as being ‘hypertension stage 2’ in general, it also registers in the same blood pressure band on the ACC/AHA (American College of Cardiology/American Heart Association) hypertension scale, which was last revised in 2017.
Your blood pressure is unhealthily high. You ought to be seeking medical advice to see what your doctor recommends for your hypertension, as you may be prescribed high blood pressure medicine to treat it if you do not already take any. The further up into the hypertension stage 2 band you are, the more likely your doctor will suggest an ambulatory blood pressure monitor to be worn, typically for a 6 or 24 hour period to determine you average reading throughout the day or night.
It is unlikely that you would recognise any symptoms yet, which only tend to manifest themselves at extremely high blood pressures, which is why high blood pressure is known as the, “silent killer”. It is recommended that you take numerous readings over different days to generate a consistent average reading, which can be easily done with one of the many cost effective blood pressure monitors available to buy for home measurements. You should also get your blood pressure checked at your doctor’s or a pharmacy in the next few days and see how the readings compare.
There are several recommended lifestyle changes you might still be able to make but seek the advice of your doctor first, for example:
Reduce Alcohol Intake and Quit Vaping or Smoking
Smoking (and vaping) or drinking too much alcohol can influence both short and long term increases in your blood pressure readings. 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.Monitor Your Weight
Obesity is associated with increased blood pressure. Losing a kilogram or 2.2 pounds will tend to reduce you blood pressure reading by 1mm of mercury (mmHg) although this relation can weaken though, so losing 10kg may only drop 6mmHg for example. Women should aim for a waist size below 89cm or 35 inches and men smaller than 89cm or 40 inches (depending on ethnic group). Carrying excess weight around the waist in particular increases the risk of high blood pressure. It is estimated that obesity accounts for 65–78% of cases of primary hypertension.Eat Healthily
Keep to a diet rich in vegetables, fruit, nuts, lean meats, fish and whole grains, together with low fat dairy products, this will help you reduce saturated fat intake levels, and should reduce your chances of acquiring obesity related hypertension. It is also important to limit the amount of sodium (salt) you have, 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, 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 dietary 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 be used to help achieve lower blood pressure as part of healthy lifestyle changes.
Exercise Often and Find Ways To Reduce Stress
If you want to achieve lower blood pressure, you should exercise for 30 minutes or more on a daily basis. This could really be any activity to get your heart rate up, like fast walking, jogging, swimming, playing football, or any other active sport. It’s also important to see if you can reduce the stress in your life. You can possibly do this by trying to avoid situations which you know will be stressful, or think about trying to change 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.Key Takeaways:
- Blood Pressure Classification: A blood pressure reading of 146/109 is universally classified as:
- ‘Hypertension Stage 2’ by EU, Japan, UK, US, and International Society of Hypertension (ISH) standards.
- Understanding the Reading:
- Systolic Pressure (when the heart contracts): 146 mmHg
- Diastolic Pressure (when the heart relaxes): 109 mmHg
- Both systolic and diastolic readings are crucial for health assessment. The less favorable of the two typically determines the overall blood pressure classification.
- If you are consistently getting readings in the Hypertension Stage 2 zone you need to seek medical advice and plan a course of action with your doctor. It is unlikely you would notice any symptoms which is why it is known as the “silent killer”.
- Blood Pulse Pressure:
- Pulse pressure is the difference between systolic and diastolic readings. For a reading of 146/109, the pulse pressure is 37mmHg. A normal pulse pressure is typically around 40mmHg.
- 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, particularly in the elderly. A pulse pressure below 25% of the systolic reading is concerning, while over 100% indicates potential risks as discussed. Yours comes in at 25%.
- Interpretations Across Countries: Different countries often have varying interpretations and classifications for the same blood pressure reading. Keep updated with their reviews and guidance.
- Normal Blood Pressure Range: Ideally, blood pressure should be between 90/60mmHG and 120/80mmHg. High blood pressure, or hypertension, rarely shows symptoms.
- Concerns and Recommendations:
- A reading of 146/109 indicates an unhealthily high blood pressure and potential hypertension problems in the future.
- Regular monitoring, lifestyle changes, and consultation with healthcare professionals are essential.
- Recommendations include maintaining a healthy weight, reducing alcohol intake, quitting smoking, exercising regularly (consult with your doctor before launching into this with high blood pressure) and managing stress.
- DASH Diet: Dietary Approaches to Stop Hypertension (DASH) can help in achieving lower blood pressure in many cases, although medication is usually required for the highest BP categorisations.