A blood pressure of 122/87 is not considered good. While the top number (122) looks relatively healthy on its own, the bottom number (87) pushes this reading into Stage 1 hypertension under current guidelines from the American Heart Association. That bottom number is doing all the work here, and it’s the reason this reading deserves attention.
Why 122/87 Counts as Stage 1 Hypertension
Blood pressure is classified into four categories: normal (below 120/80), elevated (120-129 with a bottom number still under 80), Stage 1 hypertension (130-139 or 80-89), and Stage 2 hypertension (140+ or 90+). When the two numbers fall into different categories, the higher category wins.
In your case, 122 places the top number (systolic pressure) in the elevated range. But 87 places the bottom number (diastolic pressure) squarely in Stage 1 hypertension territory, which is 80 to 89. Because the diastolic number lands in the more serious category, the entire reading is classified as Stage 1 hypertension. You’re only 3 points away from Stage 2.
What the Bottom Number Tells You
The bottom number measures the pressure in your arteries between heartbeats, when your heart is resting. A diastolic reading of 87 means the blood vessels are maintaining higher-than-ideal pressure even during that rest period. In people under 50, this typically reflects increased resistance in the smaller blood vessels throughout the body. Think of it like a garden hose that’s gotten stiff: even when you ease up on the faucet, the pressure inside stays high because the hose itself isn’t flexing the way it should.
Over time, this sustained pressure can damage artery walls, making them stiffer and less elastic. That stiffness forces the heart to work harder with every beat, which raises the risk of heart attacks, strokes, and kidney problems. The damage is gradual, which is why high blood pressure often goes unnoticed for years.
Make Sure the Reading Is Accurate
A single reading doesn’t tell the full story. Blood pressure fluctuates throughout the day, and small details during measurement can inflate the numbers by several points. Before concluding you have Stage 1 hypertension, confirm the reading with proper technique at home over multiple days.
The CDC recommends these steps for an accurate reading:
- Don’t eat, drink, or exercise for 30 minutes beforehand
- Empty your bladder first
- Sit in a chair with your back supported for at least 5 minutes before measuring
- Keep both feet flat on the floor and legs uncrossed
- Rest your arm on a table at chest height with the cuff against bare skin
- Don’t talk during the reading
- Take at least two readings, 1 to 2 minutes apart, and average them
If your diastolic number consistently lands between 80 and 89 across several days of home readings, the Stage 1 classification likely applies. If it regularly comes in under 80, that initial reading may have been a fluke caused by stress, caffeine, or poor positioning.
What Happens at Stage 1
Stage 1 hypertension doesn’t automatically mean medication. For most people at this level, the first approach is lifestyle changes, particularly if their overall cardiovascular risk is low. Your doctor will typically assess factors like age, cholesterol, blood sugar, smoking status, and family history to estimate your 10-year risk of a heart attack or stroke. That risk score determines whether lifestyle adjustments alone are enough or whether medication should be added.
The good news is that a diastolic reading of 87 is only 8 points above the normal threshold of under 80. That’s a gap that lifestyle changes alone can often close.
Lowering Your Diastolic Pressure
Diet makes the single biggest difference. Eating more fruits, vegetables, whole grains, and low-fat dairy while cutting back on saturated fat can lower blood pressure by up to 11 mmHg. The DASH diet and the Mediterranean diet are both built around this approach. That 11-point drop alone could bring a diastolic reading of 87 well into the normal range.
Sodium reduction adds another meaningful drop. Keeping sodium intake below 1,500 mg per day (roughly two-thirds of a teaspoon of table salt) can lower blood pressure by about 5 to 6 mmHg. Most of the sodium in the average diet comes from processed and restaurant foods, not the salt shaker, so reading labels and cooking at home more often are the most practical starting points.
Regular aerobic exercise, maintaining a healthy weight, limiting alcohol, and managing stress all contribute additional reductions. These effects stack, so combining several changes tends to produce a larger overall drop than any single adjustment. For someone at 122/87, getting the diastolic number below 80 is a realistic goal with consistent effort over a few months.