Blood pressure is measured using two numbers: systolic (the top number) and diastolic (the bottom number).
Systolic pressure measures the force when the heart’s ventricles pump blood out, while diastolic pressure reflects the force when the heart is at rest between beats.
For years, doctors believed that systolic pressure was the primary factor in predicting serious health issues like heart disease and stroke, often giving less importance to diastolic pressure.
However, new research from Kaiser Permanente challenges this view. A large study involving over 1.3 million adults in Northern California reveals that both systolic and diastolic pressures are crucial in assessing the risk of heart attacks and strokes.
Insights from a Large-Scale Study
The Kaiser Permanente research team analyzed more than 36 million blood pressure readings taken during routine outpatient visits between 2007 and 2016. They found that while systolic pressure has a slightly greater influence, both numbers independently affect the likelihood of cardiovascular events.
This finding was consistent across different definitions of high blood pressure. Whether hypertension was defined as 140/90 mm Hg (the older standard) or the newer, stricter threshold of 130/80 mm Hg, both systolic and diastolic readings were shown to contribute to health risks.
Implications for Health Guidelines
The study reinforces recent updates to hypertension guidelines, which advocate for tighter blood pressure control, especially in high-risk individuals. These guidelines aim to prevent complications like heart disease and stroke by managing both systolic and diastolic pressures.
The researchers emphasize that for generally healthy people, lower blood pressure readings are always better. The study’s lead author, Alexander C. Flint, highlights the need to monitor both numbers when evaluating a patient’s cardiovascular risk.
What This Means for You
If you’ve been keeping an eye on your blood pressure, it’s important to pay attention to both the systolic and diastolic numbers. While systolic pressure remains a key factor, ignoring the diastolic reading could mean missing a part of the picture.
Maintaining a healthy blood pressure—ideally below the 130/80 mm Hg threshold—can significantly reduce your risk of heart disease and stroke.
The research, published in the New England Journal of Medicine, underscores the importance of a more comprehensive approach to blood pressure management.
By focusing on both numbers, healthcare providers can better tailor treatment plans and improve long-term outcomes for patients.
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