What is "Normal" Blood Pressure?

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What is 'Normal' Blood Pressure?

Study shows we may need to go even lower

By Salynn Boyles

Dec. 12, 2002 -- Even "normal" blood pressure may increase your risk of dying from a heart attack or stroke, according to a new study. Researchers found that the higher the blood pressure, the higher the risk of dying -- even for people in the normal blood pressure range.

Researchers found that in people 40 and older, each 10-point decrease in systolic pressure -- the top number -- dropped the risk of death from stroke by 40% and the risk of death from a heart attack by 30%. This was true even for those with blood pressures considered to be normal.

"Our findings suggest that there is really no threshold when it comes to reducing [heart attack and stroke] risk," lead investigator Sarah Lewington, D.Phil, tells WebMD. "Blood pressure was strongly associated with death from heart disease and stroke, even in those in the normal range."

By current standards, blood pressure is considered high when it hits 140/90. But the new study questions this cutoff. In fact, the researchers found that the risk of death continued to fall the closer someone's blood pressure was to 115/75. Optimal blood pressure is currently thought to be less than 120/80.

In the study, published in the Dec. 14 issue of The Lancet, the researchers looked at 61 previous studies of more than one million people. Among people aged 40 to 69, a 20-point drop in systolic pressure or a 10-point fall in diastolic pressure reduced the risk of death from stroke and heart attack twofold.

The findings also suggested that blood pressure is an important cause of death from heart attack and stroke in people over the age of 70. "There has been some question about whether there is a lot of benefit to be gained by lowering blood pressure in the elderly," Lewington says. "Our analysis showed that it can definitely have an impact on deaths."

Doctors typically put patients on medication when their blood pressure is consistently above 140/90, but Lewington says the new findings and other recent studies suggest that people with lower blood pressures could benefit from treatment.

A Japanese study presented at the American Heart Association annual meeting in September found that lowering blood pressure to less than 130/85 can reverse the artery stiffness that is associated with heart disease and stroke. AHA spokesman Daniel W. Jones, MD, tells WebMD that it may be time to reconsider who should be treated. He says the issue will likely be a major topic when a national blood pressure commission meets next year.

"The problem is that we are doing a dismal job of getting people to the current goal of [below] 140/90," he says. "Our focus right now needs to be on getting larger numbers of people at least to that goal, but there is increasing evidence that there are benefits to even lower levels."

SOURCES: The Lancet, Dec. 12, 2002 • Sarah Lewington, MSc, DPhil, research fellow, Oxford University, Oxford, U.K. • Daniel W. Jones, MD, American Heart Association, executive associate dean, University of Mississippi Medical Center.

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