A new study has found that even people with “normal” blood pressure in their 30s may face a higher risk of heart attacks, strokes, or heart failure later in life—especially if their blood pressure is on the high side or rises quickly over time.
The research, led by scientists from University College London (UCL), was published in the journal Circulation: Cardiovascular Imaging.
The study followed hundreds of people for more than 40 years and found that those with slightly higher or faster-rising blood pressure in early adulthood had poorer blood flow to their heart in later life.
This reduced blood flow, measured when participants were 77 years old, is a sign that the heart muscle is not getting enough oxygen. Over time, this can lead to heart disease, stroke, and even heart failure.
Blood pressure measures how strongly blood pushes against artery walls as the heart pumps it around the body. While the heart needs some pressure to keep blood moving, too much pressure can damage arteries and make them stiff.
Over the years, this can lead to fatty deposits—known as atherosclerosis—that narrow the arteries and restrict blood flow. When blood flow to the heart drops too much, it can cause a heart attack; when it drops to the brain, it can cause a stroke.
The UCL team tracked 505 participants from the British National Survey of Health and Development, a long-term project that has followed people born in the same week of March 1946. Researchers took blood pressure readings at ages 36, 43, 53, 62, 69, and 77.
When participants reached 77, researchers used a special type of heart scan called a stress perfusion cardiovascular magnetic resonance (CMR) scan to measure how well blood flowed through the heart muscle.
The results were striking. Every 10-point increase in systolic blood pressure (the upper number in a reading, representing pressure when the heart beats) between ages 36 and 69 was linked to up to a 6% reduction in heart blood flow at age 77.
Between the critical ages of 43 and 63, the effect was even stronger—a 10-point rise in systolic pressure during this period was linked to a 9–12% drop in heart blood flow later on.
What’s most concerning is that this risk was present even for people whose blood pressure would not be considered “high.”
For example, someone whose systolic pressure rose from 120 to 140 millimeters of mercury (mmHg) over time would still be within what doctors often call the “pre-hypertension” range. Yet that increase was enough to raise their long-term risk of serious heart problems.
The study found that every 1% drop in blood flow to the heart was linked to a 3% higher risk of a major cardiac event such as a heart attack, stroke, or heart failure. The longer people lived with elevated blood pressure, the greater the damage.
For instance, if someone’s systolic blood pressure increased by 10mmHg and stayed that way from age 36 to 77, their heart’s blood flow would be about 11% lower by age 77—and they would face a 33% higher risk of a major heart issue.
Even how quickly blood pressure rises matters. If a person’s systolic pressure rose by just one point each year between ages 36 and 43, blood flow to the heart was 2% lower in later life. A one-point yearly rise between ages 53 and 63 was linked to a 5% reduction in blood flow by age 77.
Importantly, these findings held true even when researchers accounted for other factors like age, gender, body size, social background, smoking, physical activity, and diabetes. Even participants with well-controlled blood pressure in their late 70s showed signs of heart damage caused by earlier years of higher or rising blood pressure.
Dr. Gaby Captur, the senior author from UCL Institute of Cardiovascular Science, said the study shows that the heart “remembers” decades of blood pressure exposure.
“Small, steady increases in blood pressure through adulthood, even if you have a normal but high reading, can be quietly damaging the heart long before symptoms appear,” she explained. “We’ve shown that lifelong blood pressure control is an investment in how well the heart ages.”
Currently, doctors recommend blood pressure medication if systolic pressure exceeds 140 mmHg, or 130 mmHg for people with existing heart disease. But this study suggests that aiming for a reading below 120 could help preserve heart health for longer.
Professor Bryan Williams from UCL and the British Heart Foundation called blood pressure “a silent killer” because it often rises without symptoms. “This research shows that we should encourage people to get blood pressure checks from a younger age,” he said. “It’s often much easier to control when you’re young.”
Dr. Cristian Topriceanu, the study’s first author, said the findings highlight the importance of tracking blood pressure trends over time, not just relying on one-off readings.
“It’s not just how high your blood pressure is, but also how fast it rises that predicts your future heart health,” he said. Detecting those upward trends early could help prevent heart attacks, strokes, and heart failure decades later.
The researchers now plan to explore whether monitoring people’s blood pressure patterns from as early as age 18, and treating rising levels sooner, could reduce the risk of cardiovascular disease as they age. Their message is clear: protecting your heart health starts earlier than you might think, and small changes now can make a big difference later in life.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
The study is published in Circulation: Cardiovascular Imaging.
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