Blood pressure (BP) is the force exerted by circulating blood against the artery walls. A BP reading consists of two numbers, measured in millimeters of mercury (mm Hg). The higher number, the systolic pressure, represents the force when the heart beats. The lower number, the diastolic pressure, measures the pressure when the heart rests between beats. BP readings are classified using medical guidelines to determine health risks.
The Specific Classification of 138/82
A blood pressure reading of 138/82 mm Hg is classified as Stage 1 Hypertension according to the 2017 guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC). This classification recognizes that health risks begin at lower thresholds than previously defined. Stage 1 Hypertension criteria specify a systolic reading between 130 and 139 mm Hg, or a diastolic reading between 80 and 89 mm Hg. Since the systolic reading of 138 mm Hg falls within this range, the patient meets the standard. Exceeding either the systolic or diastolic threshold is sufficient for the diagnosis, signaling a need for lifestyle adjustments and medical attention.
Understanding the Full Blood Pressure Spectrum
Current guidelines define five distinct categories of blood pressure for risk assessment and intervention. Normal blood pressure is less than 120/80 mm Hg. The next category is Elevated blood pressure, defined by a systolic pressure of 120 to 129 mm Hg and a diastolic pressure less than 80 mm Hg. Stage 1 Hypertension begins at 130/80 mm Hg, reflecting a significantly increased cardiovascular risk and prompting the need for intervention. Stage 2 Hypertension begins when the systolic pressure is 140 mm Hg or higher, or the diastolic pressure is 90 mm Hg or higher. This level indicates a greater need for aggressive management, often involving medication alongside lifestyle changes. The most severe category is the Hypertensive Crisis, requiring immediate medical attention. This emergency range is defined by a systolic reading higher than 180 mm Hg and/or a diastolic reading higher than 120 mm Hg.
Essential Lifestyle Adjustments for This Reading
For Stage 1 Hypertension, the first line of defense involves aggressive non-pharmacological interventions aimed at naturally reducing blood pressure. Adopting the Dietary Approaches to Stop Hypertension (DASH) eating plan is highly recommended. This plan focuses on increasing the intake of fruits, vegetables, and whole grains. The diet emphasizes foods rich in potassium, calcium, and magnesium, which naturally counterbalance the effects of sodium.
Sodium reduction is crucial. Aim for an intake of no more than 1,500 milligrams per day for a greater blood pressure lowering effect, although 2,300 milligrams per day is the maximum recommended limit. This requires avoiding processed foods and carefully reading nutrition labels. Increasing potassium intake, found in foods like bananas, spinach, and beans, also helps promote sodium excretion.
Physical activity is a cornerstone of management, combining aerobic and resistance exercises. Adults should aim for at least 90 to 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking or jogging. This activity can be broken up into 30-minute sessions most days of the week. Supplementing this with dynamic resistance training, like weight lifting, two to three non-consecutive days per week, further aids in blood pressure reduction.
Limiting alcohol consumption is advised, as excessive intake raises blood pressure and can interfere with medication effectiveness. For men, this means no more than two drinks per day, and for women, no more than one drink per day. Stress management techniques help mitigate the temporary blood pressure spikes and chronic elevation caused by stress hormones. Practices like deep breathing exercises, mindfulness meditation, or progressive muscle relaxation activate the body’s relaxation response.
Medical Monitoring and Treatment Strategy
For an initial Stage 1 reading, the medical strategy typically prioritizes a period of observation combined with lifestyle intervention. Patients without a history of cardiovascular disease and a low 10-year risk of atherosclerotic cardiovascular disease (ASCVD) are advised to implement comprehensive lifestyle changes for three to six months. Regular follow-up appointments during this period are used to monitor the effectiveness of these non-pharmacological efforts. The provider reassesses BP using both in-office measurements and home blood pressure monitoring data for a more accurate average.
If the blood pressure goal of less than 130/80 mm Hg is achieved through lifestyle changes, monitoring continues every three to six months. If BP remains elevated after six months, or if the patient has existing risk factors like diabetes or chronic kidney disease, medication may be introduced. Drug therapy is individualized, often starting with a single antihypertensive agent to support reaching the target blood pressure range.