'Normal' Blood Pressure Threshold May Differ Between Men and Women

Woman getting her blood pressure measured.

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Key Takeaways

  • Research has found that women have a lower threshold for developing complications due to high blood pressure.
  • The data suggest a systolic reading of 110 mm Hg or higher put women at risk of heart disease.
  • Doctors say this supports growing evidence that a woman's "normal" blood pressure range should be lowered.

A new study has found that women have a lower threshold for developing complications due to high blood pressure when compared to men. Current guidelines consider a healthy blood pressure range to be the same for men and women.

The February study, which was published in the journal Circulation, studied blood pressure readings from 27,542 participants without heart disease that were taken as part of four community-based cohort studies.

The researchers found a significant difference in systolic blood pressure—the first number in a blood pressure reading—which measures the force of the blood against the artery wall as the heartbeats. The second number, the diastolic pressure, measures blood pressure against artery walls between heartbeats.

What Is Considered "Normal" Blood Pressure?

Nearly half of Americans have high blood pressure, according to the American Heart Association (AHA). Blood pressure numbers are divided into the following categories, per the AHA:

  • Normal: Systolic less than 120 and diastolic less than 80
  • Elevated: Systolic 120 to 129 and diastolic less than 80
  • High (hypertension stage 1): Systolic 130 to 139 and diastolic 80 to 89
  • High (hypertension stage 2): Systolic 140 or higher and diastolic 90 or higher
  • Hypertensive crisis: Systolic higher than 180 and/or diastolic higher than 120

The researchers found that 120 mm Hg was the threshold for hypertension in men. Systolic blood pressure readings above that were linked with a higher risk of developing any type of heart disease, including heart attack, heart failure, and stroke.

But the number was lower for women. The researchers discovered that women who had a systolic reading of 110 mm Hg or higher were at risk of developing heart disease, heart attack, and stroke.

“Our results suggest that cardiovascular risk from blood pressure occurs at a lower blood pressure in women than men,” study co-author C. Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles, tells Verywell. “For blood pressure levels, including levels currently considered ‘normal,’ women face a higher cardiovascular risk of death and morbidity.”

Merz says that she decided to study the topic because “sex differences are abundant in health and disease.”

The idea that women might have a lower threshold for blood pressure in relation to heart disease risk isn’t new—Merz says that doctors are already aware that men and women are impacted differently by high blood pressure. “Hypertension is the most common risk factor for cardiovascular disease and women suffer disproportionately with higher rates of death and morbidity with cardiovascular disease compared to men,” she says. “Therefore, evaluation of blood pressure differences by sex would be important to understanding and closing disparity gaps for women.”

What This Means For You

Established guidelines for hypertension may not completely reflect your risk of the disease. If you’re concerned about your hypertension risk, talk to your doctor about steps you can take to lower your blood pressure.  

The Risk of Hypertension

Hypertension, also known as high blood pressure, happens when the force of blood flowing through your blood vessels, is consistently too high.

When your heart beats, it creates pressure that pushes blood through your blood vessels to help deliver it to your tissues and organs. The pressure, known as your blood pressure, happens as blood pumps out of the heart and as it rests between heartbeats.

When you have high blood pressure, it increases the workload of your heart and blood vessels. That makes the blood vessels work harder and perform less efficiently.

If you consistently have high blood pressure, the force and friction of that pressure damages the tissue inside your arteries, the blood vessels that deliver blood your heart to your tissues. Cholesterol can also form a plaque along small tears in the artery walls. As plaque increases, along with damage, the arteries get smaller and blood pressure raises. That leads to even more harm to the arteries, heart, and other areas of the body.

What's Next?

The findings “raise awareness and raises the need to look at this more,” Jennifer Wong, MD, cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California, tells Verywell. She points out that studies are needed to look into the effects of treating women at a lower blood pressure threshold before this would become common practice.

Jennifer Haythe, MD, co-director of the Women's Center for Cardiovascular Health at Columbia University Irving Medical Center in New York, agrees. “While we have data to support the fact that women have lower blood pressure overall compared with men, this study is interesting as it shows that elevations above that lower baseline—but below traditional cut-offs—are associated with increased risk of cardiovascular events,” Haythe tells Verywell. Haythe also says the findings could eventually “lead to sex-specific changes in goal blood pressure readings for women compared with men.” 

Nicole Weinberg, MD, cardiologist at Providence Saint John’s Health Center in California, tells Verywell that it’s “great for the data to reflect what we see clinically. We often see women showing signs of end-organ damage at lower blood pressure levels. Now we have the data to support lowering their blood pressure to different thresholds than their male counterparts.”

Merz is hopeful her findings will prompt more research into sex-specific blood pressure thresholds. “Further research should consistently consider and include sex as a biological variable,” she says.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ji H, Niiranen T, Rader F, et al. Sex differences in blood pressure associations with cardiovascular outcomesCirc. 2021;143(7):761-763. doi:10.1161/circulationaha.120.049360

  2. American Heart Association. The Facts About High Blood Pressure. November 30, 2017.

  3. American Heart Association. What is High Blood Pressure? October 31, 2016.

By Korin Miller
Korin Miller is a health and lifestyle journalist who has been published in The Washington Post, Prevention, SELF, Women's Health, The Bump, and Yahoo, among other outlets.