Blood Pressure 146 Over 40–120: Which Are OK?
With an upper value of 146, the answer depends on your lower number. Here are all readings, sorted by what they mean.
On its own, a systolic (upper) value of 146 mmHg is Hypertension stage 1 by the international categories (2023 ESH guideline) and Stage 2 hypertension under the 2025 AHA/ACC guideline. The worse of your two numbers decides the category, so a raised diastolic (lower) value moves a 146 reading up: from 146/100 it counts as stage 2, from 146/110 it counts as stage 3. Readings below 146/86 have a pulse pressure above 60 mmHg — a wide gap that is common after 60 and worth mentioning to your doctor.
Hypertension stage 1 146/40 to 146/99
- 146/40 ↓
- 146/41 ↓
- 146/42 ↓
- 146/43 ↓
- 146/44 ↓
- 146/45 ↓
- 146/46 ↓
- 146/47 ↓
- 146/48 ↓
- 146/49 ↓
- 146/50
- 146/51
- 146/52
- 146/53
- 146/54
- 146/55
- 146/56
- 146/57
- 146/58
- 146/59
- 146/60
- 146/61
- 146/62
- 146/63
- 146/64
- 146/65
- 146/66
- 146/67
- 146/68
- 146/69
- 146/70
- 146/71
- 146/72
- 146/73
- 146/74
- 146/75
- 146/76
- 146/77
- 146/78
- 146/79
- 146/80
- 146/81
- 146/82
- 146/83
- 146/84
- 146/85
- 146/86
- 146/87
- 146/88
- 146/89
- 146/90
- 146/91
- 146/92
- 146/93
- 146/94
- 146/95
- 146/96
- 146/97
- 146/98
- 146/99
↓ = the lower number is below 50: these readings count as stage 1 by the upper number, but the low lower number needs checking — see each page.
Hypertension stage 2 146/100 to 146/109
Hypertension stage 3 146/110 to 146/120
What to do with a reading of 146 over …
Measure at home for 7 days, morning and evening, and take the average to your doctor. A home average of 135/85 or more confirms high blood pressure. From 146/110 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 146/49 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.