What does having high blood pressure mean for your future cardiac health?

This study looked at the effects high blood pressure can have on overall future heart health. 

Hypertension (high blood pressure) is a common medical condition where pressure in the blood vessels is too high. Uncontrolled high blood pressure causes the heart to have to work harder in order to pump blood. Over time, this added workload on the heart causes the heart to weaken resulting in complications such as abnormal heart rhythm, heart attack, or sudden loss of heart function (cardiac arrest).

Blood pressure is measured in millimeters of mercury (mmHg). For blood pressure readings two numbers are shown – the top number which measures the pressure in the arteries when the heart is beating (systolic blood pressure: SBP) and the bottom number which measures the pressure in the arteries when the heart is relaxing or filling (diastolic blood pressure: DBP).

Blood pressure is considered normal at around 120/80 mmHg. People can have both of these values increased (SBP-DBP), or only isolated systolic hypertension or isolated diastolic hypertension when only one of these values is increased. The difference between the systolic and diastolic pressure readings is called the pulse pressure. A normal pulse pressure is generally around 40mmHg. A pulse pressure greater than this may be a strong predictor of heart problems. A pulse pressure lower than 40 may mean poor heart function. 

This study looked at whether isolated SBP, isolated DBP, SBP-DBP, and pulse pressure can predict the outcome and course (prognosis) of heart heath in patients with hypertension.

The study included 1,924 participants aged 44-74 years. Blood pressure for each participant was measured at office times (by health care provider) and at home, because it is likely to fluctuate throughout the day. The occurrence of a heart event (e.g. heart attack, stroke) was recorded.

Over 11 years, 236 individuals had suffered a heart event. SBP-DBP was found to be associated with the highest risk of a heart event, nearly tripling the chances of a heart event when compared with participants with normal blood pressure levels. Isolated SBP and isolated DBP approximately doubled the chances of a heart event compared to participants with normal blood pressure levels. Also home, but not office, high pulse pressure was found to be a predictor of heart event risk. Every 10mmHg increase in pulse pressure was associated with a 21% increase in cardiovascular risk.

This study concluded that SBP-DBP, isolated DBP and isolated SBP increase the risk of heart problems. Therefore, patients with these different types of high blood pressure require close monitoring and treatment. The study also concluded that home blood pressure measurements provide more accurate risk predictions than office blood pressure and should be encouraged for individuals with high blood pressure. 

It cannot be certain that measurements that were taken at home by participants were taken correctly or on a regular basis. 

If you, or someone you know, have high blood pressure, talk to a doctor about the risks high blood pressure can have, home monitoring, and what steps you can take to achieve normal blood pressure.