Pay Attention to Both Numbers for Healthy Blood Pressure

Pay Attention to Both Numbers for Healthy Blood Pressure

130/80. That is the new normal for blood pressure. In 2017, The American Heart Association published that people with a blood pressure measurement over 130/80 are considered to have hypertension. A lot of people tend to pay more attention to the top number (systolic pressure) than the bottom number (diastolic pressure). New research has shown that both diastolic and systolic pressure are equally as important in determining a person's risk of heart disease.

This study was published Wednesday in the New England Journal of Medicine by researchers at Kaiser Permanente in California. "Although systolic does count for a little bit more in terms of the risk of heart attack and stroke, diastolic high blood pressure is a close second, and it's an independent predictor of those risks," said lead author Dr. Alexander Flint, a stroke specialist with Kaiser Permanente.

Dr. Flint added that a high diastolic number "really should not be ignored". "We should not declare victory just because one number is under control. We need to pay attention to both." The study included 36 million blood pressure readings from 1.3 million adults. All of the participants were members of Kaiser Permanente in Northern California. Most of the participants were white; just 7.5% were black.

"Recognizing that the diastolic blood pressure also has to be controlled because it can increase risk for stroke is a good step forward in our management for blood pressure," said Dr. Nieca Goldberg, a cardiologist at NYU Langone Medical Center.

Over the past ten years, many studies have shown how patients can reduce their risk of heart attack and stroke by decreasing their blood pressure to normal levels. "This is something I've believed for years, that we should treat both systolic and diastolic blood pressure," said Dr. Angela Brown, an associate professor of medicine and clinical hypertension specialist at Washington University School of Medicine. "I emphasize this point in training my students, residents and fellows because they often tend to ignore the diastolic pressure," Brown said.

Brown also noted that younger people tend to have higher diastolic readings than systolic readings, for example, 130/100 mmHg, compared to older people who's systolic readings may be higher like 170/80 mmHg. Systolic and diastolic hypertension can both be treated with the same kinds of medications, but some people may need to have their medications or doses altered to ensure they can get their blood pressure below 130/80 mmHg. "Everybody's reaction to medication is different, so it really has to be individually tailored," Flint said.

The American Heart Association recommends the following ways to lower your blood pressure and keep it in a healthy range.

  • Eat a well balanced-diet which is low in sodium
  • Exercise regularly, 30 min/day, 5 days/week
  • Lose weight if your BMI is higher than 25

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  • Limit alcoholic drinks to 2/day for men and 1/day for women.
  • Refrain from smoking.


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