Our sedentary lifestyle and rich diets are killing our blood pressure
So you think your blood pressure is normal? Think again.
The latest iteration of an
“ideal” blood pressure — a level of 120 millimeters of mercury for systolic pressure, the top number — that Americans are urged to achieve and maintain has been called into question by a longterm multiethnic study of otherwise healthy adults.
The study, published in June in JAMA Cardiology, found that as systolic blood pressure rose above 90 mm, the risk of damage to coronary arteries rose along with it. Systolic blood pressure represents the pressure within arteries when the heart pumps (as opposed to diastolic blood pressure, the lower smaller number, when the heart rests).
The new findings suggest a need to look more carefully at why, despite considerable overall improvements in risk factors for heart disease in recent decades, it remains the nation’s leading killer.
Starting in the 1940s, cardiovascular researchers have unveiled evidence that Americans live in a society that all but guarantees a disproportionately high risk of developing and dying of heart disease. Since my first weeks writing for this newspaper in the early 1960s, I’ve publicized their advice urging people to curb preventable risks to their hearts and blood vessels.
Although significant progress has been made along several fronts, especially drastic cuts in cigarette smoking and lowered levels of artery-damaging cholesterol, atherosclerotic heart disease still kills far too many people in this country long before they reach their potential life span. If not for a plethora of therapeutic advances, like antihypertensive drugs, cholesterol-lowering statins and openheart surgery to bypass clogged arteries, life expectancy would be a lot worse for many people.
But the overall picture suggests we’ve still got a long way to go. For example, as Americans get fatter, two major risk factors for heart disease — Type 2 diabetes and high blood pressure — rise along with readings on bathroom scales.
Yes, there are medications to treat both conditions. But why resort to pills, including drugs with unwanted side effects, to modify risks that are within the personal control of most people?
And as shown in the study, even levels of blood pressure that are generally considered “normal” may indeed be high enough to foster the development of atherosclerotic heart disease by more than fourfold above the risk faced by people with systolic blood pressures that are physiologically ideal.
Heart experts have long known that people in traditional nonindustrial societies typically maintain systolic blood pressures in the low 90s throughout life. Unlike typical Americans, their blood pressure does not rise with age. Rather, it seems, the increase in blood pressure most common among Americans as they age into mid- and late adulthood is an artifact of our sedentary lifestyles and diets too rich in calories and high in sodium, all of which result in stiff, narrowed arteries that result in high blood pressure.
Levels of what doctors consider a healthy systolic blood pressure have been falling for about half a century. In August 1950, a report in JAMA suggested that labeling systolic blood pressures of 140, 150 or 160 mm as abnormally high is “arbitrary, particularly when age is concerned.” The authors suggested that raising acceptable blood pressure levels for people over 40 “would result in a decrease in the reported incidence of hypertension and thus allay some of the widespread and unnecessary fear regarding high blood pressure.”
The latest blood pressure advisory, issued in 2017 by the American Heart Association and American College of Cardiology, considers a systolic blood pressure of 120 mm the upper limit of normal, and defines 130 mm and above as high blood pressure that warrants treatment with lifestyle measures or medication.