Most of us have learned that the healthiest blood pressure for which we should aim is 120/80.
Researchers now think that this may not apply to everyone, however, and that it may be harmful and even deadly for some.
An international team of researchers published a study in the August 2016 edition of the Lancet concluding ideal or low blood pressure increased the likelihood of heart attack in people with coronary artery disease.
They analyzed the data from 22,672 coronary artery disease (CAD) sufferers from 45 countries collected between 2009 and 2010. While all the participants had CAD, their conditions were stable, meaning that those who experienced regular blood clots or blocked arteries were excluded. All these patients were being treated for high blood pressure.
After a five-year follow-up, it unsurprisingly turned out that patients with a systolic blood pressure count of 140 mmHg or higher had greater risk of heart attack and stroke. The same held for those with a diastolic score of 80 and up. That means that you should treat your blood pressure if it reaches 140/80 or higher. (Yes, a diastolic score over 80 is a tad too high.) So far, so relatively familiar results.
However, their data also showed that those with a systolic score of below 120 and a diastolic score of below 70 were at an equally great risk of heart attack, and were equally likely to suffer heart failure or death.
Compared with people with scores between 120-139 and 70-79, those with scores below 120 and 70 had a 56 and 41 percent greater chance of heart attack respectively.
According to their calculations, a score of between 120 and 139 over a score between 70 and 79 was the ideal level for people with CAD to prevent heart attack. The same did not hold for stroke, as their patients’ risk of stroke declined further as their blood pressure dropped.
In general, then, to prevent both heart attack and stroke, you should keep your blood pressure as low as possible (to avoid stroke) without falling below 120/70.
Why is this important?
Coronary artery disease is the result of atherosclerosis, a condition in which your blood vessels are narrowed or partly blocked, usually by cholesterol. Because of the plaques on your arterial walls, your arteries become brittle (calcified, as the scientists say.) Under these conditions, they can break or can become completely blocked if blood flows too fast through them; that is, if your blood pressure is too high.
On the other hand, plaques on arterial walls do block blood from flowing comfortably through your vessels, which consequently requires some blood pressure to force it through. That is why insufficient blood pressure can cause heart attack in these patients. Without sufficient blood pressure, your blood cannot be forced through these partially blocked arteries, and your heart gets too little blood to function.
The Global Burden of Disease Study in 2013 found that coronary artery disease was the number one cause of death around the world. This has encouraged many physicians to be unnecessarily extreme about tackling high blood pressure, one of the factors that contributes to its development.
This study, then, demonstrates why doctors should resist the temptation to treat high blood pressure too aggressively in people with CAD.
Now if you don’t have CAD and your blood pressure is over 120/80 or if you have CAD and your blood pressure is above 140/80, you need to take action to lower it.
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