Blood Pressure 180 Over 46–160: Which Are OK?
With an upper value of 180, the answer depends on your lower number. Here are all readings, sorted by what they mean.
On its own, a systolic (upper) value of 180 mmHg is Hypertension stage 3 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 180 reading up: every listed reading stays in the same category. Readings below 180/120 have a pulse pressure above 60 mmHg — a wide gap that is common after 60 and worth mentioning to your doctor.
Hypertension stage 3 180/46 to 180/160
- 180/46 ↓
- 180/60
- 180/61
- 180/62
- 180/63
- 180/64
- 180/65
- 180/66
- 180/67
- 180/68
- 180/69
- 180/70
- 180/71
- 180/72
- 180/73
- 180/74
- 180/75
- 180/76
- 180/77
- 180/78
- 180/79
- 180/80
- 180/81
- 180/82
- 180/83
- 180/84
- 180/85
- 180/86
- 180/87
- 180/88
- 180/89
- 180/90
- 180/91
- 180/92
- 180/93
- 180/94
- 180/95
- 180/96
- 180/97
- 180/98
- 180/99
- 180/100
- 180/101
- 180/102
- 180/103
- 180/104
- 180/105
- 180/106
- 180/107
- 180/108
- 180/109
- 180/110
- 180/111
- 180/112
- 180/113
- 180/114
- 180/115
- 180/116
- 180/117
- 180/118
- 180/119
- 180/120
- 180/121
- 180/122
- 180/123
- 180/124
- 180/125
- 180/126
- 180/127
- 180/128
- 180/129
- 180/130
- 180/131
- 180/132
- 180/133
- 180/134
- 180/135
- 180/136
- 180/137
- 180/138
- 180/139
- 180/140
- 180/141
- 180/142
- 180/143
- 180/144
- 180/145
- 180/146
- 180/147
- 180/148
- 180/149
- 180/150
- 180/151
- 180/152
- 180/153
- 180/154
- 180/155
- 180/156
- 180/157
- 180/158
- 180/159
- 180/160
↓ = the lower number is below 50: these readings count as stage 3 by the upper number, but the low lower number needs checking — see each page.
What to do with a reading of 180 over …
Sit quietly for 5 minutes and measure again. If it is still 180/110 or higher, contact a doctor the same day — and call 911 (US) or your local emergency number right away if you have 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 180/46 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.