Healthy Blood Pressure May Be Lower Than You Think

For many years, 140/90 was considered the maximum for healthy blood pressure, but a large-scale study came out in 2015 that challenged that standard. Before I go into what that study found, you may be wondering why you’re just hearing about a change in blood pressure recommendations 10 years after the new information became available.

Well, it comes down to the fact that health care providers are human beings and human beings like their traditions. As I said, 140/90 was the traditional limit for a long time and it has stuck.

So what did the “new” research find?

Well, the study tracked cardiovascular risk over a period of years in hypertension patients who were placed in two groups. One group was treated with the goal of keeping blood pressure to just below 140/90. The second group was treated more aggressively, with the goal of keeping blood pressure to around 120/80. After one year, the statistical risk of serious cardiovascular events was about the same, but then things started to change.

After 2 years, the risk was significantly higher in the 140/90 group. The increased risk continued to grow over the following 2 years before it was stopped. The study was originally planned to continue for several years, but because of the rapidly increasing risk to those in the 140/90 group, it would have been unethical to keep going.

Now, 120/80 was the goal that was achieved in the majority of the study participants in the second group. It is speculated by some experts that even greater benefits might be seen if blood pressure was maintained at an even lower level, but this has not yet been investigated in large-scale multi-year studies.

It’s also important to note that blood pressure in this study was controlled with medication and in the 120/80 group, sometimes multiple medications were used to achieve that level. While this reduced cardiovascular risk substantially, it raised the risk of kidney disease. Some blood pressure medications act on kidney function, which may account for some of this adverse effect. In addition, when blood pressure falls too low for too long, kidney function can be adversely affected, and this may account for some of the increase risk.

With this in mind, while medication may be needed to achieve and maintain a more healthy blood pressure near the 120/80 mark, non-medication methods (especially avoiding medications that act on the kidneys) are preferable when they are effective.

There are several things you can do to lower and maintain blood pressure in that 120/80 (or somewhat lower) range.

Exercise is top of the list. Almost any type of exercise is usually beneficial for blood pressure. “Cardio” is the classic exercise recommendation, although there is a simple exercise I’ve discussed previously that has been shown to be the most effective for lowering blood pressure.

In addition to exercise, you’ve probably heard that consuming too much salt (sodium chloride) will drive your blood pressure up. It’s really more the balance between sodium and potassium that’s at play here than just your total sodium intake. A simple way to improve that balance if you salt your food is to switch from regular salt (100% sodium chloride) to a mixture of sodium and potassium chloride, such as that in Morton’s Lite Salt.

It’s also important to get adequate magnesium, and as this it is one of the most common deficiencies in Americans, taking a magnesium supplement is probably a good idea, as discussed in this article.

Beyond diet and exercise, managing stress can be a big help in maintaining healthy blood pressure. Some people do best with mentally-focused approaches like meditation, while others find more physically active approaches more beneficial. Whatever your preferred stress-management method is, taking time to engage in it at least a few times per week is highly recommended.

For some people, chiropractic, massage, and/or acupuncture can provide significant benefits in this area as well, as pain and altered neuromuscular function may trigger autonomic nervous system responses that drive up blood pressure.

The takeaway here is if you’ve been shooting for under 140/90 as your target blood pressure, it’s probably time to adjust your aim and try to get down to 120/80 or lower. If you need medication to get there, ask your doctor about starting with medications that don’t directly impact the kidneys.

Until next time…

George F. Best, D.C.