A blood pressure reading contains two numbers, and both can tell doctors something important about heart health.
New research suggests that the lower number may be especially useful for understanding future heart risk in younger adults.
The top number is called systolic blood pressure. It measures the pressure inside the arteries when the heart contracts and pushes blood around the body.
The bottom number is diastolic blood pressure. It measures the pressure that remains in the arteries while the heart relaxes between beats.
For many years, doctors considered both numbers when judging whether someone had high blood pressure. More recently, greater attention has often been given to systolic pressure because it tends to be a stronger predictor of heart disease, particularly as people get older.
Researchers from the University of Southern Denmark wanted to examine whether this focus could overlook useful information. They studied long-term health data from more than 107,000 people between the ages of 19 and 97.
None of the participants had known cardiovascular disease when the study began. The researchers followed their health for up to 26 years and recorded major events such as heart attacks, strokes and deaths related to heart and blood vessel disease.
The results confirmed that systolic blood pressure was generally the stronger predictor of future cardiovascular problems. Its connection with risk remained important across different ages and in both men and women.
However, diastolic pressure also provided useful information, particularly among people younger than 50. In this age group, the lower number added information about future cardiovascular risk beyond what researchers could learn from systolic pressure alone.
This finding matters because high blood pressure is often thought of as a problem mainly affecting older people. Younger adults can also develop hypertension, and the condition may quietly damage blood vessels for years before symptoms or major health problems appear.
The researchers also examined mean arterial pressure, often shortened to MAP. This measure uses both the systolic and diastolic readings to estimate the average pressure in the arteries during a heartbeat cycle.
Mean arterial pressure also performed well in predicting cardiovascular risk. The finding supports the idea that information contained in both blood pressure numbers can be useful rather than relying on a single measurement in every situation.
High blood pressure is a major cause of preventable illness worldwide. Over time, excessive pressure can damage artery walls and place extra strain on the heart, increasing the risk of heart attack, stroke, heart failure, kidney disease and other serious problems.
Blood pressure also changes throughout the day and can be affected by exercise, stress, caffeine, medicines and even the way it is measured. Doctors therefore often use repeated readings rather than a single result before deciding whether someone has hypertension.
Healthy habits can help many people control their blood pressure. Regular physical activity, eating a balanced diet, limiting excess salt, maintaining a healthy weight, avoiding smoking and following prescribed treatment can all help reduce cardiovascular risk.
The study was led by Dr. Michael Hecht Olsen of the University of Southern Denmark and was published in the American Heart Association journal Hypertension. The findings suggest that systolic pressure remains a powerful measure of cardiovascular risk, but the diastolic number should not simply be ignored, especially in younger adults.
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