Heart DiseasePreventive Medicine

SYSTOLIC BLOOD PRESSURE AND HEART DISEASE

We’ve known for decades that high blood pressure and heart disease go hand in hand. The higher a patient’s blood pressure, the greater the likelihood of a heart attack, coronary artery disease, stroke, and vascular disease in general. Increased tension in blood vessel walls and the higher force exerted on them by blood flow contribute to the development of hardening of the arteries.

Recently, new information has emerged that stresses the importance of good blood pressure control. Physicians have for many years been more concerned about the diastolic blood pressure, DBP, the lower of the two numbers. But information published in the JAMA Cardiology journal places new emphasis on lowering of the systolic blood pressure, SBP.

A study that included 1457 patients followed for 14.5 years, showed that for every 10 mmHg (the parameter used to measure blood pressure) increase in SBP, there was a 53% higher risk for Arteriosclerotic Cardiovascular Disease, ASCVD. This was determined by measuring the presence of coronary artery calcium. Even at SBP’s of 90-129 there was risk. Normal SBP has been lowered to 110 so even at a normal SBP level the risk of ASCVD is present. The higher the SBP the greater the development of coronary calcium and coronary artery disease.

Obviously, when one’s SBP runs 160 mmHg for many years, from the results of this study, we can see significant vascular disease occurs. It used to be said doctors didn’t need to be concerned about SBP, but this study proves otherwise.

BOTTOM LINE: The lower your Systolic Blood Pressure, the less your chances for developing ASCVD.

Dr. G’s Opinion: If you can tolerate a systolic blood pressure of 90 mmHg you’re probably better off for it. But with a SBP that low, one is subject to weakness, lightheadedness, and drops in blood pressure when going from sitting to standing. Many people do poorly in this situation. My feeling is try to keep your SBP at a level of 110-120 which has always been considered normal. Maybe you are at a slightly higher risk for vascular disease, but your risk of fainting or falling because of weakness and low blood pressure is a lot less.

Reference: https://www.docwirenews.com/DocWire-pick/cardiology-picks.

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