Blood Pressure 178 Over 44–160: Which Are OK?
With an upper value of 178, the answer depends on your lower number. Here are all readings, sorted by what they mean.
On its own, a systolic (upper) value of 178 mmHg is Hypertension stage 2 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 178 reading up: from 178/110 it counts as stage 3. Readings below 178/118 have a pulse pressure above 60 mmHg — a wide gap that is common after 60 and worth mentioning to your doctor.
Hypertension stage 2 178/44 to 178/109
- 178/44 ↓
- 178/60
- 178/61
- 178/62
- 178/63
- 178/64
- 178/65
- 178/66
- 178/67
- 178/68
- 178/69
- 178/70
- 178/71
- 178/72
- 178/73
- 178/74
- 178/75
- 178/76
- 178/77
- 178/78
- 178/79
- 178/80
- 178/81
- 178/82
- 178/83
- 178/84
- 178/85
- 178/86
- 178/87
- 178/88
- 178/89
- 178/90
- 178/91
- 178/92
- 178/93
- 178/94
- 178/95
- 178/96
- 178/97
- 178/98
- 178/99
- 178/100
- 178/101
- 178/102
- 178/103
- 178/104
- 178/105
- 178/106
- 178/107
- 178/108
- 178/109
↓ = the lower number is below 50: these readings count as stage 2 by the upper number, but the low lower number needs checking — see each page.
Hypertension stage 3 178/110 to 178/160
- 178/110
- 178/111
- 178/112
- 178/113
- 178/114
- 178/115
- 178/116
- 178/117
- 178/118
- 178/119
- 178/120
- 178/121
- 178/122
- 178/123
- 178/124
- 178/125
- 178/126
- 178/127
- 178/128
- 178/129
- 178/130
- 178/131
- 178/132
- 178/133
- 178/134
- 178/135
- 178/136
- 178/137
- 178/138
- 178/139
- 178/140
- 178/141
- 178/142
- 178/143
- 178/144
- 178/145
- 178/146
- 178/147
- 178/148
- 178/149
- 178/150
- 178/151
- 178/152
- 178/153
- 178/154
- 178/155
- 178/156
- 178/157
- 178/158
- 178/159
- 178/160
What to do with a reading of 178 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 178/110 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 178/44 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.