Now always talk about hypertension, many people know the standard of hypertension, blood pressure greater than or equal to 140/90 mm Hg is hypertension. 140 is the standard of systolic blood pressure, that is, high pressure, and 90 is the standard of diastolic blood pressure, that is, low pressure. Regardless of "high pressure" or "low pressure", there is a high even if it is high blood pressure.
But what should normal blood pressure be? Is blood pressure below 140/90mmHg normal?
Of course not.
There is also a lower limit for blood pressure, the lower normal limit of systolic blood pressure is 90mmHg, and the lower normal limit of diastolic blood pressure is 60mmHg.
What about the upper limit? Nor is it normal that systostolic blood pressure is less than 140mmHg and diastolic blood pressure is less than 90mmHg, or it should be further distinguished. Although sometimes doctors will also say in general terms that systolic blood pressure of 90 to 139 mmHg and diastolic blood pressure of 60 to 89 mmHg are normal, in fact, normal blood pressure is also subdivided, divided into normal blood pressure and normal high value blood pressure.
Normal blood pressure is below 120/80mmHg, which is the most ideal, so it is also called "ideal blood pressure".
Normal high-value blood pressure is 120~139/80~89mmHg.
Why is it so divided?
Because studies have found that the damage of high blood pressure begins to increase from the normal high value of blood pressure.
According to the data of the Continental Epidemiological Survey, the cardiovascular risk of people with blood pressure levels at normal high values, that is, 120 to 139/80 to 89 mmHg, after 10 years, the cardiovascular risk is more than 1 times higher than that of people with blood pressure at 110/75 mmHg, and after 10 years, 45% and 64% of people will become hypertensive patients.
The same is true of foreign survey results. Long-term observations of people with baseline blood pressures from 115/75 mmHg to 185/115 mmHg have found that blood pressure levels are positively correlated with stroke, coronary heart disease events, and cardiovascular death. That is, from normal blood pressure upwards, the higher the blood pressure, the higher these cardiovascular events and cardiovascular deaths. Specifically, for every 20 mmHg increase in systolic blood pressure, or for every 10 mmHg increase in diastolic blood pressure, the risk of cardiovascular disease increases exponentially. In Asians like mainland China, hypertension and stroke are more closely related than coronary heart disease, where every 10 mmHg increase in blood pressure increases the risk of stroke by 53 percent and the risk of fatal myocardial infarction increases by 31 percent.
Elevated blood pressure levels are also associated with heart failure, atrial fibrillation, and renal failure.
Normal high blood pressure increases cardiovascular risk, so it is not so "normal". Therefore, it is necessary to pay attention to normal high blood pressure.
It is also because studies have found that patients benefit more from lower blood pressure.
Earlier studies observed that blood pressure was reduced below 140/90 mmHg, and hypertensive patients could benefit from antihypertensive therapy, reducing cardiovascular events and reducing cardiovascular mortality, so the target value of blood pressure reduction was set below 140/90 mmHg.
In recent years, there have been medical studies trying to lower blood pressure to observe efficacy and safety, one of the more famous studies is the "Systolic Blood Pressure Intervention Clinical Trial" (SPRINT study). This study is to compare whether the systolic blood pressure is lowered below 120mmHg or below 140mmHg, which is better. It was found that for high-risk hypertension patients, including the elderly, but not those with diabetes or stroke, reducing blood pressure below 120mmHg can significantly reduce the incidence of major cardiovascular adverse events and all-cause mortality. That is, it is better to drop below 120mmHg.
Of course, in this group of reduced blood pressure, the incidence of some adverse events has also increased, such as hypotension, syncope, hyponatremia, and decreased glomerular filtration rate. Therefore, specific to the patient, it still needs to be individualized. But overall, when it is tolerated, the blood pressure drops a little lower, better.
For these reasons, the U.S. hypertension guidelines set 130 to 139/80 to 89 mmHg as the standard for first-degree hypertension. Our country has not changed the diagnostic criteria for hypertension because there are different opinions on the results of this study, but it is recommended that patients with hypertension who can tolerate it or some are at high risk should further control their blood pressure below 130/80mmHg.
Therefore, the true normal, that is, the ideal blood pressure standard, is less than 120/80mmHg.
Incidentally, the low limit for normal blood pressure is 90/60mmHg, but it is not that blood pressure below this level is sick. Young people, thinner people, especially young women, blood pressure will also be lower than this level, but as long as there are no other diseases, no blood supply deficiencies, and no special treatment is required.
Also, the diastolic pressure (low pressure) in the elderly is also reduced, it will be lower than 60mmHg, which is mostly the result of arteriosclerosis, and a small number of people have lesions with aortic valves and aortic valve insufficiency. Such hypertensive patients, pay attention to when lowering blood pressure, if necessary, you can slightly relax some of the criteria for lowering systolic blood pressure.
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