≥ 130/80mmHg
Definition of hypertension
2025 Canadian definition in adults, with a validated device and under optimal conditions.2,3
Health education · Heart and blood vesselsSaint‑Hyacinthe
High blood pressure: understanding, measuring and better controlling your blood pressure
An often silent disease that can affect the heart, brain, kidneys and blood vessels.
Hypertension, also called high blood pressure, is a persistent increase in the pressure that blood exerts on the walls of the arteries. It is common and often causes no symptoms.8
At the Clinique IPS du Palais in Saint-Hyacinthe, a blood pressure assessment may include standardized measurements, a review of your risk factors, home measurements or ambulatory monitoring when indicated.
The 2025 benchmarks at a glance
Three numbers to know
≥ 140/90mmHg
Threshold for medication
One of the main thresholds at which Hypertension Canada recommends drug treatment.4
< 130mmHg systolic
Treatment target
Recommended target when treatment is well tolerated.4
These numbers assume a measurement taken correctly. According to Hypertension Canada, a non-standardized clinic measurement is on average 5 to 10 mmHg higher than a standardized measurement.3 A single measurement is generally not enough to make a diagnosis.
Understanding
What is blood pressure?
Blood pressure is the pressure that blood exerts on the walls of the arteries.8
It is expressed as two numbers, in millimetres of mercury (mmHg).
Systolic pressure is the pressure in the arteries when the heart contracts and pushes out blood. Diastolic pressure is the pressure present when the heart relaxes between two beats.
Sample reading
128/76mmHg
- 128Systolic: when the heart contracts
- 76Diastolic: when the heart relaxes
Definition
What is hypertension?
According to Hypertension Canada’s 2025 guidelines, hypertension in adults is defined as a blood pressure of 130/80 mmHg or higher, measured with a validated device and under optimal conditions.2,3
This is a significant change: since 2015, the Canadian diagnosis had been based on an automated office measurement of at least 135/85 mmHg.5
Defining hypertension and deciding to start a medication are two different things. A person with a blood pressure of 132/82 mmHg does not automatically need a medication.
The decision depends, among other things, on:
- repeated measurements;
- home or ambulatory measurements;
- age and medical history;
- cardiovascular risk;
- the presence of diabetes, kidney disease or cardiovascular disease;
- and the overall clinical situation.
Measuring
Why a single measurement is generally not enough
Blood pressure varies constantly. A single measurement therefore does not necessarily represent your usual blood pressure.
It can be influenced by physical activity, stress, pain, caffeine, tobacco, certain medications, temperature, lack of sleep, anxiety or simply the way the measurement is taken.
Hypertension Canada recommends assessing blood pressure outside the office to confirm a diagnosis.4
- At the clinic, standardized measurement
- At home (HBPM)
- Over 24 hours (ABPM)
White coat hypertension
Blood pressure is high at the clinic but normal outside the office. The stress associated with the appointment or the measurement can temporarily raise blood pressure.
According to the 2025 guidelines, this situation is present in 15% to 30% of people whose blood pressure is high in the office.2
Masked hypertension
This is the opposite situation: blood pressure is normal at the clinic but high at home or during usual activities. It can go unnoticed if you rely only on measurements taken in the office.
Its prevalence is estimated at 10% to 15%.2
Technique
How to measure blood pressure correctly
A poorly performed measurement can skew the results. Hypertension Canada recommends validated automated oscillometric devices.3
Before and during the measurement
Cuff size matters
An unsuitable cuff can change the result. It must fit the arm.2
The 2020 Canadian recommendations specified that the width of the inflatable bladder should correspond to about 40% of the arm circumference, and its length should cover 80% to 100% of that circumference.6
Also follow your device manufacturer’s instructions.
Both arms
Should blood pressure be measured in both arms?
During a first assessment, it is useful to compare the blood pressure in both arms. A small difference is common.
The 2020 Canadian recommendations advised measuring both arms at least once and, if one arm consistently has a higher pressure, using that arm for measurements.6 The 2024 European recommendations define an inter-arm difference as a systolic difference of more than 10 mmHg.11
To learn more
Why the difference between arms matters, how it is measured and when it warrants an assessment.
At home
How to measure your blood pressure at home
Home blood pressure measurement (HBPM) provides several readings under your usual conditions.
In the morning
Two measurements, one minute apart.7
In the evening
Two measurements, one minute apart.7
For 7 days
The standardized protocol: 2 measurements, 2 times a day, for 1 week.3
The average
The 2020 Canadian recommendations advised excluding the readings from the first day.6 The protocol can be adapted to your situation.
Which device should you choose?
- automated;
- upper arm;
- validated;
- with a suitable cuff.
The Government of Quebec recommends choosing a blood pressure monitor bearing the “Recommended by Hypertension Canada” mark.9
What average is considered high?
Since 2025, Hypertension Canada has used the same threshold of 130/80 mmHg for an optimal clinic measurement, the home average and the daytime average of ABPM.2,5
Previously, a home average of 135/85 mmHg or higher was considered high.6 You will therefore still see this number in some documents.
The health professional takes into account the method and the average of the readings, not a single isolated number.
24-hour ABPM
What is ABPM?
Ambulatory blood pressure monitoring (ABPM) automatically measures your blood pressure during your usual activities and while you sleep, generally for about 24 hours.
It measures blood pressure at intervals of 20 to 30 minutes, day and night. According to Hypertension Canada, out-of-office readings, and ABPM in particular, are more closely linked to cardiovascular events.3
Method2025 thresholdBefore 2025
Office, optimal measurement≥ 130/80≥ 135/85
Home, average≥ 130/80≥ 135/85
ABPM, daytime average≥ 130/80≥ 135/85
Thresholds in mmHg. Sources: Hypertension Canada 2025 and 2020 recommendations.2,5,6 Before 2025, a 24-hour average above 130/80 mmHg was also considered high.6 These values must be interpreted by a health professional.
ABPM can be particularly useful to:
- confirm hypertension;
- look for white coat hypertension;
- look for masked hypertension;
- analyze blood pressure during the night;
- better understand highly variable readings;
- assess certain symptoms of low blood pressure;
- check how well treatment is working.
Does hypertension cause symptoms?
Often not.
The Government of Quebec points out that hypertension generally does not cause symptoms. When they are present, it mentions mild headaches, dizziness, shortness of breath and vision problems.8
These symptoms are not specific. You cannot tell whether your blood pressure is normal based on how you feel.
Why does it matter if I don’t feel anything?
Blood pressure that is too high for several years can gradually damage blood vessels and certain organs.
Hypertension is one of the main cardiovascular risk factors.
Complications
What complications can be associated with hypertension?
The Government of Quebec mentions heart, brain, kidney and eye complications.8
The heart
Including myocardial infarction (heart attack) and heart failure.
The brain
High blood pressure increases the risk of stroke.
The kidneys
The kidneys have a very extensive network of small blood vessels that prolonged hypertension can damage.
The eyes
The small blood vessels of the retina can also be affected.
Causes
What factors contribute to hypertension?
According to the Government of Quebec:8
Modifiable factors
A diet high in sodium, excessive alcohol consumption, physical inactivity, weight, smoking and stress.
Non-modifiable factors
Age (55 and over) and family history, among others.
Health problems
Anxiety, sleep apnea, kidney disease and hormonal disorders.
Diabetes, although not on this list, is among the situations considered high cardiovascular risk in the 2025 guidelines.2
Can certain medications raise blood pressure?
Yes.
The 2020 Canadian recommendations mentioned, among others:6
- non-steroidal anti-inflammatory drugs;
- oral contraceptives;
- corticosteroids and anabolic steroids;
- oral decongestants (pseudoephedrine);
- certain antidepressants (MAOIs, certain SSRIs);
- cyclosporine, tacrolimus and erythropoietin;
- supplements sold without a prescription;
- licorice;
- cocaine and amphetamines.
When hypertension is difficult to control, all medications must be reviewed. Do not stop a medication without talking to your health professional.
What is secondary hypertension?
In most adults, hypertension is called primary or essential: it results from a combination of several factors. Sometimes it is caused or worsened by another condition: this is called secondary hypertension.
The 2020 Canadian recommendations cited, among others, kidney failure, renovascular disease, primary hyperaldosteronism, thyroid disease, pheochromocytoma and other rare endocrine causes, as well as obstructive sleep apnea.6
When should further testing be done?
The 2025 guidelines recommend considering screening for secondary causes in cases of resistant hypertension.2 The health professional may also investigate when hypertension appears at a very young age, worsens suddenly, when tests show abnormalities or when symptoms suggest a specific cause.
Assessment
What tests may be ordered?
The assessment is not just about measuring blood pressure.
For a new diagnosis, the 2020 Canadian recommendations suggested a urinalysis, potassium, sodium and creatinine, fasting blood glucose or glycated hemoglobin (A1c), a lipid profile and a 12-lead ECG.6
Other tests may be added depending on medical history or symptoms, along with an assessment of overall cardiovascular risk.
Can an ECG be useful?
The electrocardiogram records the electrical activity of the heart. It can be part of the cardiovascular assessment and provide additional information depending on the context.
Sleep
Can sleep apnea raise blood pressure?
Yes.
Obstructive sleep apnea is one of the possible causes of secondary hypertension,6 and the Public Health Agency of Canada lists hypertension among its complications.12 It can contribute to blood pressure that is difficult to control in some people.
It should be considered, for example, in the presence of:
- snoring;
- pauses in breathing at night;
- sleepiness;
- significant fatigue;
- frequent awakenings.
Treatment
How is hypertension treated?
Treatment depends on the blood pressure level, cardiovascular risk, other illnesses, age, tolerance and your preferences. It may include lifestyle changes, medications, or both.
The 2025 guidelines recommend adopting healthy lifestyle habits for all adults with hypertension.4
Reduce sodium
More than 70% of the sodium consumed in a typical Western diet comes from processed foods rather than salt added at the table.2
Cooking more often with minimally processed foods, comparing labels and choosing lower-salt products can help.
Eat well
A diet rich in vegetables, fruit, whole grains, legumes and plant-based proteins promotes cardiovascular health.
The 2020 Canadian recommendations described a DASH-type diet: rich in fruit, vegetables, fibre and non-animal protein, and low in saturated fat and cholesterol.6
Being active
The 2025 guidelines adopt the World Health Organization’s advice: at least 150 to 300 minutes of moderate-intensity aerobic activity per week.2
The amount and intensity should take your health status into account.
Reduce alcohol
In people who have 3 or more drinks per day, cutting back is associated with a drop in systolic blood pressure.2
Quitting smoking
All people with hypertension should receive advice to quit smoking.2 Quitting smoking reduces overall cardiovascular risk.
Weight
Weight loss is recommended for people living with obesity.2
A comprehensive approach takes into account diet, physical activity, metabolic health and realistic goals.
Medications
When is medication started?
According to Hypertension Canada’s 2025 guidelines, drug treatment is recommended:4
Cardiovascular risk is considered high, for example, in the presence of established cardiovascular disease, diabetes, chronic kidney disease, a 10-year Framingham risk score of at least 20% or age 75 and over.2
- Blood pressure of 140/90 mmHg or higher
- Or systolic pressure of 130 to 139 mmHg with high cardiovascular risk
- Target: systolic below 130 mmHg if well tolerated
Which medications are used?
The 2025 guidelines recommend low-dose combination therapy using medications from 2 of these 3 classes, ideally in a single pill:4
- angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs);
- thiazide or thiazide-like diuretics;
- long-acting dihydropyridine calcium channel blockers.
If needed, all three classes can be combined, and other medications then added.4 The choice depends on age, other conditions, kidney function, test results, medications already being taken and side effects.
Why continue if my blood pressure is normal?
Normal blood pressure while on treatment generally means that the treatment is working, not that the hypertension has gone away.
Do not stop or change a blood pressure medication without discussing it with the health professional who provides your follow-up.
What if my blood pressure gets too low?
Blood pressure that is too low can sometimes cause dizziness, weakness, light-headedness, blurred vision, feeling faint or a risk of falling. The treatment may then need to be reassessed: the target must always be well tolerated.
When should I seek emergency care?
Very high blood pressure accompanied, for example, by:
- chest pain or pressure;
- significant shortness of breath;
- sudden weakness or paralysis;
- difficulty speaking or confusion;
- loss of vision;
- sudden neurological symptoms;
- loss of consciousness;
may be a medical emergency.
Call 911 when a situation suggests a cardiovascular or neurological emergency.
Very high blood pressure without symptoms?
A high number must always be interpreted in context. A very high reading should first be repeated correctly after a few minutes of rest when the situation allows.
Particularly high blood pressure warrants a prompt assessment. High blood pressure accompanied by serious symptoms must not wait for a regular clinic appointment.
Hypertension and pregnancy
This page is about adults outside of pregnancy. During pregnancy, the thresholds and management are specific, particularly to look for gestational hypertension or preeclampsia.
Hypertension assessment and follow-up in Saint-Hyacinthe
At Clinique IPS du Palais, depending on your situation, the assessment may include: a standardized blood pressure measurement, a comparison of both arms, an analysis of your home readings, an assessment of cardiovascular risk, a medication review, blood work when needed, an assessment of certain secondary causes, starting or adjusting treatment when indicated, and follow-up of its effectiveness and tolerance.
Depending on the context, certain additional tests may also be considered, such as 24-hour ABPM, an ECG or the ankle-brachial index.
Frequently asked questions
Frequently asked questions
Is 130/80 now considered high blood pressure in Canada?
Yes. Hypertension Canada’s 2025 guidelines define hypertension in adults as a blood pressure of at least 130/80 mmHg measured with a validated device and under optimal conditions. This does not mean that a medication must automatically be started at 130/80.
Is 140/90 still important?
Yes. According to the 2025 Canadian recommendations, a medication is recommended starting at 140/90 mmHg. With a systolic pressure between 130 and 139 mmHg, it is recommended when cardiovascular risk is high.
Why is my blood pressure always higher at the doctor’s office?
It may be a white coat effect. Home measurements or ambulatory blood pressure monitoring (ABPM) can help clarify the situation.
What is a good blood pressure at home?
Since the 2025 guidelines, Hypertension Canada has used the same threshold of 130/80 mmHg for an optimal clinic measurement, the home average and the daytime average of ABPM. Previously, a home average of 135/85 mmHg or higher was considered high. Interpretation must take into account the protocol used.
Do I need to take my blood pressure every day?
Not necessarily. How often depends on the context. During an initial assessment or a change in treatment, a structured series of measurements can be useful. Once your blood pressure is stable, less frequent monitoring may be enough.
Can I take my blood pressure right after a coffee?
Hypertension Canada recommends not smoking, not consuming caffeine and not going to the bathroom in the 30 minutes before the measurement. Also follow the protocol provided by your health professional.
Can high blood pressure go away?
For some people, major lifestyle changes or treating a secondary cause can considerably lower blood pressure. For many people, however, hypertension is a chronic condition that requires long-term monitoring.
Key takeaways
Hypertension is common and usually silent. In Canada, the 2025 recommendations define it in adults as blood pressure of 130/80 mmHg or higher, measured properly.
A diagnosis should generally not be based on a single reading: confirmation may require repeated readings, home readings or ABPM.
When hypertension is confirmed, management aims not only to lower the numbers but above all to reduce the risk of cardiovascular disease, stroke, kidney disease and other long-term complications.
Sources
- Hypertension Canada. Lignes directrices sur les soins primaires 2025. 2025, accessed October 5, 2026. hypertension.ca
- Goupil R et al. Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care. Canadian Medical Association Journal (CMAJ), May 26, 2025; 197. doi:10.1503/cmaj.241770, accessed October 5, 2026. hypertension.ca (PDF)
- Hypertension Canada. Diagnostic (2025 guidelines). Accessed October 5, 2026. hypertension.ca
- Hypertension Canada. Recommandations (2025 guidelines). Accessed October 5, 2026. hypertension.ca
- Hypertension Canada. Appendix 2 : Responses to frequent questions received during the public external review phase (2025 guidelines). May 2025, accessed October 5, 2026. hypertension.ca (PDF)
- Hypertension Canada. Hypertension Highlights 2020 : A Practical Guide informed by the Hypertension Canada Guidelines. 2020, accessed October 5, 2026. These recommendations predate the 2025 recommendations. hypertension.ca (PDF)
- Hypertension Canada. Comment puis-je surveiller ma pression artérielle? Undated, accessed October 5, 2026. hypertension.ca
- Government of Quebec. Hypertension artérielle. Updated January 30, 2025, accessed October 5, 2026. quebec.ca
- Government of Quebec. Prévention et dépistage des maladies cardiovasculaires. Updated January 30, 2025, accessed October 5, 2026. quebec.ca
- Institut national de santé publique du Québec (INSPQ). Hypertension artérielle (surveillance indicator, 2024-2025 data). Accessed October 5, 2026. inspq.qc.ca
- McEvoy JW, McCarthy CP, Bruno RM et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. European Heart Journal, August 30, 2024; 45(38):3912-4018, accessed October 5, 2026. academic.oup.com
- Public Health Agency of Canada. L’apnée du sommeil. Modified August 15, 2017, accessed October 5, 2026. canada.ca
The information on this page is provided for informational purposes and does not replace an assessment by a health professional.