A Simple Guide To Understanding Your Blood Pressure Numbers

And here's why you really should pay attention to those BP numbers.

Diagnosed with high blood pressure? For years, the standard treatment has been to cut your systolic blood pressure—the top number—to less than 140 millimeters of mercury (mm Hg).

But that might not be low enough to really protect your heart: Reducing your blood pressure even further can add years to your life, new research from the New England Journal of Medicine suggests.

In the study, people with high blood pressure who achieved the systolic target of 120 mm Hg or less were 27 percent less likely to die of any cause over a 3-year follow up than people with high blood pressure who aimed for a systolic reading of 140 mm Hg or less.

They were also 38 percent less likely to develop heart failure and 43 percent less likely to die due to cardiovascular causes. 

It’s not really surprising that you’re better off with lower BP, says study coauthor Paul K. Whelton, M.D., an epidemiologist at Tulane University School of Public Health and Tropical Medicine. 

High blood pressure means that your heart pumps blood more forcefully, which over time stretches and damages your blood vessels. Then, when fat in your blood—due to high LDL, or bad cholesterol—flows through, it gets caught in the marred vessels, and begins to clump inside them.

This causes atherosclerosis, or the buildup of plaque inside your arteries, which triggers an inflammatory response throughout your body. As a result, you’re at higher risk of stroke, heart disease, kidney disease, and other life-threatening conditions—all which can lead to death well before your time.

The more you reduce your blood pressure—as long as you don’t develop low blood pressure—the better it is for your blood vessels, Dr. Whelton says.

You just don’t want it get too low. In the study, those in the lower-target BP group were also at higher risk of developing hypotension, which is defined as a drop in systolic blood pressure of at least 20 points within one minute after standing up. They were also more likely to experience side effects like fainting.

However, hypotension is preventable with careful monitoring. If your doctor thinks you’re at risk, he’ll have you regularly check your blood pressure at home and adjust your meds accordingly. (Here’s The Best Way to Take Your Own Blood Pressure.)

While the study looked at folks 50 and older, Dr. Whelton believes younger guys can reap the benefits of achieving a lower systolic blood pressure, too.

In fact, it may even be more beneficial for young guys with high BP to lower that number, he says. More years of plaque buildup means a greater lifetime risk of a heart or stroke.

Of course, talk to your doctor about the risks and benefits of shooting for a lower number.

For one, it’s not easy to do: Nearly 50 percent of Americans with hypertension don’t have it controlled below 140 mm Hg, according to the National Health and Nutrition Examination Survey.

And in order to get it to that low level, multiple meds are often needed, says Dr. Whelton. So discuss with your doctor whether adding more drugs—which increases your chances of side effects—to get there is worth the added risk.    

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