Looking beyond the numbers of high blood pressure

When it comes to your blood pressure reading, which matters the most—the top number or the bottom number?

It seems like a simple question. And it’s certainly a common one, given how regularly it comes up in my office.

But believe it or not, the answer has long been a source of controversy, even among doctors.

As it turns out, everyone’s wrong—or right, depending on how you look at it. Because according to a new study, both systolic (top number) and diastolic (bottom number) hypertension pose significant risks to your heart.

The lower, the better?

This study looked at more than 30 million blood pressure measurements from over one million patients. Researchers analyzed a complete scope of cardiovascular outcomes—including rates of both heart attack and stroke (ischemic or hemorrhagic)—over a period of eight years.

Researchers used two different hypertension thresholds from the revised guidelines that the American College of Cardiology (ACC) and the American Heart Association (AHA) issued back in 2017.

As you may recall, the official high blood pressure (hypertension) diagnosis threshold dropped from 140/90 to 130/80, which used to be considered prehypertension. And accordingly, just under 20 percent of study subjects had hypertension using the higher threshold—while nearly half were diagnosed as hypertensive using the lower threshold.

Researchers found that high systolic measurements tended to increase with age—and that high diastolic measurements peaked around age 50, in particular.

Both measurements had independent links to heart risk. But ultimately, systolic hypertension was more dangerous, increasing risk by 18 percent—versus a six percent increase with diastolic hypertension, even when using the lower threshold of 130/80.

The high price of hard targets

This study used a relatively healthy subject pool—but other studies, featuring patients with coronary artery disease, showed that lowering diastolic blood pressure below 70 mm Hg might actually increase heart risk.

So rather than simply arguing that everyone should start receiving intensive blood pressure monitoring, researchers actually advised doctors to use caution for a change. They specifically warned against lowering blood pressure too aggressively in patients who are elderly, frail, or who already suffer from cerebrovascular or coronary artery disease.

And, well… it’s about time. I’ve been pushing for simple common sense on this issue for decades—ever since I was in medical school.

For one thing, older people with stiff arteries and high systolic blood pressure paired with low diastolic blood pressure have what we call “wide pulse pressure,” which is notoriously difficult to treat without side effects (like blackouts, falls, and kidney damage). So if you set aggressively low targets, you’re really playing with fire.

Sure, this study identifies some obvious tipping points when it comes to blood pressure and heart health. And it’s clear that, for most people, lower blood pressure is better.

But what isn’t clear is how many drugs—with dangerous adverse effects—might be required to get you there.

One-size-fits-all just doesn’t apply when it comes to health issues. That’s why a better approach would be to focus on lowering high blood pressure as a whole, safely and significantly, without a specific target in mind.

And that’s exactly why I’ve developed my own all-natural plan to prevent and reverse America’s biggest killers—high blood pressure, heart attack, and stroke. This natural approach, which I call the Ultimate Heart-Protection Protocol, incorporates diet, supplement, and lifestyle recommendations to keep your blood pressure in a range that’s healthy for you. So what are you waiting for? Click here to learn more about this innovative learning tool, or to sign up today.

Source:

“Systolic, Diastolic BP Both Contribute to Cardiovascular Risk.” Medscape Medical News, 07/25/2019. (medscape.com/viewarticle/916035)