Blood Pressure 118 Over 40–112: Which Are OK?
With an upper value of 118, the answer depends on your lower number. Here are all readings, sorted by what they mean.
On its own, a systolic (upper) value of 118 mmHg is Ideal (optimal) by the international categories (2023 ESH guideline) and Normal under the 2025 AHA/ACC guideline. The worse of your two numbers decides the category, so a raised diastolic (lower) value moves a 118 reading up, and a lower number below 60 makes it low: below 118/60 it counts as low, from 118/80 it counts as normal, from 118/85 it counts as high normal, from 118/90 it counts as stage 1, from 118/100 it counts as stage 2, from 118/110 it counts as stage 3. Readings below 118/58 have a pulse pressure above 60 mmHg — a wide gap that is common after 60 and worth mentioning to your doctor.
Low blood pressure 118/40 to 118/59
Ideal (optimal) 118/60 to 118/79
Hypertension stage 1 118/90 to 118/99
Hypertension stage 2 118/100 to 118/109
What to do with a reading of 118 over …
A good upper value. Re-check at least once a year, and use the average of several readings rather than a single one. From 118/110 the lower number makes it stage 3: sit quietly for 5 minutes and measure again; if it stays at 110 or higher, contact a doctor the same day, and call 911 (US) or your local emergency number with chest pain, shortness of breath, back pain, numbness or weakness, vision or speech problems, confusion or a severe headache. A lower number below 50 (from 118/49 down) is clearly low: measure again, and if it is confirmed or you feel dizzy, faint or confused, contact a doctor the same day. Keep your readings in a free blood pressure log and read how to measure correctly.
Sources: ESH 2023 guideline · AHA/ACC 2025 guideline.