In adults, the pressure is optimal at 120/80 mmHg, and hypertension is considered to be present when 140/90 mmHg is measured in the clinic. Contrary to a common misconception, this threshold does not change with age: what adapts in older people is the treatment goal, not the definition. Here are the clear benchmarks, without the misleading charts.
Understanding the two digits
Blood pressure is measured by two values, expressed in millimeters of mercury (mmHg). The systolic pressure is the first number; the higher value corresponds to the force exerted when the heart contracts and propels blood. The diastolic pressure is the second number; it measures the pressure that remains between two beats, when the heart relaxes.
A blood pressure of 120/80 mmHg is commonly read as «12-8» in France. The two numbers together indicate that a high systolic pressure with a normal diastolic pressure is not insignificant, especially in the elderly.
Reference values in adults
European cardiology recommendations establish clear categories that apply to all adults:
| Category | Systolic | Diastolic |
| Optimal | less than 120 | and less than 80 |
| Normal | 120 to 129 | and/or 80 to 84 |
| Normal high | 130 to 139 | and/or 85 to 89 |
| Hypertension (clinic) | 140 or more | and/or 90 or more |
At home, the threshold for hypertension is set lower: 135/85 mmHg. This difference is explained by the «white coat effect», an increase in blood pressure linked to the medical context of the clinic. This is one of the reasons why the French recommendations value repeated self-measurement.
What changes with age and what doesn’t
This is the point that is most misunderstood. Over the years, the arteries lose elasticity, blood circulates in stiffer vessels, and systolic pressure tends to increase mechanically. This is a common physiological phenomenon, especially isolated systolic hypertension after age 60.
⚠ Frequent does not mean normal. Many charts show values like 150/90 as «normal» after 60 or 70 years. This is a myth. The threshold for hypertension (140/90 in the office) remains the same at 70 years as at 40 years, and high blood pressure remains a risk factor for cardiovascular disease at any age.
What really adapts to the elderly is the therapeutic goal, not the definition of hypertension. In people over 65, recommendations often aim for a systolic pressure between 130 and 139 mmHg. After 80 years of age, or in frail individuals, the doctor avoids aiming for too low values (below 120/70) to limit the risks of falls and discomfort, and sets an individualized goal. It is therefore the treatment goal that adapts to the individual, never the threshold that defines the disease.
Men, women: a real difference
Sex influences the evolution of tension. Men show higher numbers on average from a young age. Women are relatively protected until menopause: the drop in estrogen then leads to a often more marked increase in blood pressure. After 50 to 55 years, the gap between the two sexes tends to reverse.
Why a single measure is never enough
A single value does not allow conclusions to be drawn. A tension experienced after a cup of coffee, a climb up a flight of stairs, or a moment of stress does not reflect the usual level. It is the repetition of measurements that counts.
The reference method is the so-called «3-3» or «2-2-3» protocol: two to three measurements in the morning and evening, for several days in a row, from which the average is calculated. It is this average, not a single number, that guides the medical discussion.
One detail changes everything: the size of the brace. Too small, it overestimates the tension; too large, it underestimates it. If the arm circumference exceeds the brace’s range, you need to change the brace before you doubt its tension.
When to consult?
It is recommended to seek medical advice if the blood pressure regularly exceeds 140/90 mmHg over several days of measurement, if there are unusual symptoms (persistent headaches, dizziness, visual disturbances), or if there is a family history of hypertension. Conversely, a low blood pressure (below 100/60 mmHg) may be normal for some people, but warrants a consultation if it is accompanied by dizziness or discomfort.
In all cases, the interpretation of a blood test is up to the doctor. Self-monitoring is intended to provide reliable data on the duration, not to diagnose the condition yourself.
Equipping yourself well for self-measurement
Home self-measurement is only valuable if the device is reliable and used properly. A clinically validated, certified tonometer with a wristband adapted to the arm circumference is the prerequisite for effective monitoring. In France, nearly a third of adults have blood pressure levels above the recommended thresholds, and a significant portion of them are unaware of this due to a lack of regular measurements, which is why it is important to have an accessible and reliable device available in pharmacies.
Smart Agents Healthcare manufactures white-label electronic blood pressure monitors, Clinically validated, ISO 13485 certified and compliant with the MDR 2017/745 regulation. Backlit display, multi-user memory, arrhythmia detection and WHO indicator: everything to equip a reliable range of self-diagnosis devices for pharmacies and groups.
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FAQ
Verified sources
• Categories ESC (optimal <120/80, HTA ≥140/90 cabinet): Cardiologues.net, Mezurilo
• Auto-measurement threshold 135/85 and effect of a white blouse: Aroma-Zone (HAS markings)
• Myth of the paintings «normal high tension by age»: eifs.fr, Mezurilo
• Senior target 130-139 mmHg, individualized after 80 years: Clinique Saint-Jean, eifs.fr
• Menopause and gender differences: IRCEM, Mezurilo, Santiane
• Protocol 2-2-3 and the importance of the size of the armband: Mezurilo
• ~1 third of French adults are hypertensive: Cardiologues.net, Radiology Marseille
Note: This article is for informational purposes only and does not replace medical advice. The interpretation of a blood pressure reading is the responsibility of the doctor.
