We know that our blood pressure (BP) can reveal a lot about our cardiovascular risk factor for heart disease. About 50 years ago, the diastolic, or lower number, was the one causing more concern if elevated and more predictive of cardiovascular events (CV) than the systolic number. More recently, The systolic, or top number, may be deemed more important although both are important to maintain at normal levels (NEJM JW Gen Med Dec 15 2017 and J Am Coll Cardiol 2018; 71:e127).

A multivariable analysis (data collected on systolic and diastolic blood pressures) were collected to determine the 8 year CV outcomes (heart attack, stroke) in more than 1 million adults, average age 53, from North California’s Kaiser Permanente health system. The researchers found that for systolic BP’s of 136 and 160 mm Hg, the predicted 8 year risks for CV events were 1.9% and 4.8% respectively. On the other hand, for diastolic BP’s of 81 and 96 mmHg, CV event rates were 1.9% and 3.6% respectively.

This shows that both systolic and diastolic BP are independent predictors of adverse cardiovascular outcomes. In general, an ideal BP should be less than 130/80. Do you know your blood pressure?

Reference: Flint AC et al. Effect of systolic and diastolic blood pressure on cardiovascular outcomes. N Engl J Med 2019 Jul 18; 381:243