"High-Normal" Blood Pressure Unsafe

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"High-Normal" Blood Pressure Unsafe

"High-normal" blood pressure (BP), defined as systolic pressure of 130 to 139 mm Hg and/or diastolic pressure of 85 to 89 mm Hg, has long been considered to be in a safe range, but this view is changing.

Information regarding the risk of cardiovascular disease in those with high-normal BP is limited, although studies have demonstrated that higher BP is correlated with higher disease risk.

To evaluate the risk of cardiovascular disease in individuals with high-normal BP, the authors examined data from 6,859 subjects in the Framingham Heart Study. For the study, BP at baseline and cardiovascular disease incidence 12 years later were considered. The results for those with high-normal BP:

Women were 2.5 times more likely to have heart disease and men were 1.6 times more likely to have heart disease than those with optimal BP.

After 10 years, 4% of women and 8% of men age 35 to 65 had some form of heart disease.

Between ages 65 and 90, disease risk jumped to 18% for women and 25% for men.

A quarter of the subjects had high-normal BP.

The authors conclude, "Our findings emphasize the need to determine whether lowering high-normal blood pressure can reduce the risk of cardiovascular disease." They encourage the reduction of BP to "normal" levels, especially in the elderly, diabetics, and those with multiple risk factors.

Vasan RS, Larson MG, Leip EP, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. The New England Journal of Medicine 2001:345(18), pp. 1291-1297.