Keep Your Blood Pressure Low

High blood pressure increases risk of chronic diseases

But you can lower your blood pressure

High blood pressure predicts higher risk of cardiovascular disease, stroke, and premature mortality. In 2017, the American College of Cardiology and other organizations changed the level of systolic blood pressure used to define hypertension from 140 to 130 mm Hg. You may think that because your most recent blood pressure reading was 125/90 and don’t have hypertension, you’re in the clear. Not so fast! A new study showed that systolic blood pressure above 90 mm Hg predicted higher risk of atherosclerotic cardiovascular events and detectable levels calcium in coronary arteries.

Participants in the Multi-Ethnic Study of Atherosclerosis (MESA) included 1,457 women and men with an average of 58.1 years. At baseline, participants didn't have traditional atherosclerosis risk factors, their systolic blood pressure at baseline did not exceed 129 mm Hg, and their blood fats were in the normal range. After an average follow-up of 14.5 years, compared to participants whose systolic blood pressure fell to between 90-99 mm Hg, participants with systolic blood pressure of 100-109 mm Hg had a 200 percent higher risk of developing atherosclerosis. Participants with systolic blood pressure of 120-129 mm Hg had a 358 percent higher risk. Risk of atherosclerosis and the presence of calcium in the coronary arteries increased in a step-wise manner as systolic blood pressure increased from 90-99 mm Hg to 120-129 mm Hg. Thus, if your recent blood pressure was 125/90, lowering it could reduce your risk of atherosclerosis.

We Americans tend to assume that systolic blood pressure automatically increases with age. But this is not always true. Increased cardiorespiratory fitness predicts reduced blood pressure. Might people with higher cardiorespiratory fitness delay the onset of high blood pressure as they age? Researchers used data from 13,953 men of high education and high socioeconomic status who participated in the Aerobics Center Longitudinal Study to test this idea. Men with high, moderate, and low fitness developed hypertension (defined in this study as 140/90) at rates of 6.7, 9.3, and 11.9 percent, respectively. Men in the highest one-third of cardiorespiratory fitness category delayed their increase in systolic blood pressure above 120 mm Hg for 8 years (from age 46 to 54 years) compared to men in the lowest one-third of fitness. Thus, maintaining high cardiorespiratory fitness may postpone or eliminate high blood pressure later in life along with its unhealthy effects.

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