Blood Pressure 128 Over 40–118: Which Are OK?
With an upper value of 128, the answer depends on your lower number. Here are all readings, sorted by what they mean.
On its own, a systolic (upper) value of 128 mmHg is Normal by the international categories (2023 ESH guideline) and Elevated under the 2025 AHA/ACC guideline. The worse of your two numbers decides the category, so a raised diastolic (lower) value moves a 128 reading up: from 128/85 it counts as high normal, from 128/90 it counts as stage 1, from 128/100 it counts as stage 2, from 128/110 it counts as stage 3. Readings below 128/68 have a pulse pressure above 60 mmHg — a wide gap that is common after 60 and worth mentioning to your doctor.
Normal 128/40 to 128/84
- 128/40 ↓
- 128/41 ↓
- 128/42 ↓
- 128/43 ↓
- 128/44 ↓
- 128/45 ↓
- 128/46 ↓
- 128/47 ↓
- 128/48 ↓
- 128/49 ↓
- 128/50
- 128/51
- 128/52
- 128/53
- 128/54
- 128/55
- 128/56
- 128/57
- 128/58
- 128/59
- 128/60
- 128/61
- 128/62
- 128/63
- 128/64
- 128/65
- 128/66
- 128/67
- 128/68
- 128/69
- 128/70
- 128/71
- 128/72
- 128/73
- 128/74
- 128/75
- 128/76
- 128/77
- 128/78
- 128/79
- 128/80
- 128/81
- 128/82
- 128/83
- 128/84
↓ = the lower number is below 50: these readings count as normal by the upper number, but the low lower number needs checking — see each page.
Hypertension stage 1 128/90 to 128/99
Hypertension stage 2 128/100 to 128/109
What to do with a reading of 128 over …
Normal internationally, though above the ideal of under 120 (the US calls it elevated). Re-check once or twice a year and keep an eye on salt, weight and exercise. From 128/110 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 128/49 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.