You know the routine. You get your blood pressure measured when you visit your physician. But when your doctor pumps up that blood pressure cuff, they give you two numbers that correspond to your blood pressure, known as systolic and diastolic. While both are important, you might wonder if one has more impact on your health than the other. Let’s look closer.
What Each Blood Pressure Measurement Means
What do those numbers mean for your health? Think of it this way – the top number is the “showtime” pressure. That’s your systolic reading, measuring the force in your arteries when your heart is contracting and doing its thing. The bottom diastolic number is the “intermission” pressure, between beats when your heart takes a breather.
When your doc reads off those blood pressure digits, let’s say 120 over 80, that top number – 120 in our example – shows your arteries flexing hard as your heart beats. That’s your systolic pressure taking a load off, so to speak. The bottom figure – 80 here – is the diastolic one. Consider it your blood vessels chilling between pulses as the heart refills.
Now one of these can wiggle too high or dip too low even if the other hangs out in the healthy zone. But it’s also possible for both numbers to take a walk on the too tight or too loose side. Getting to know your personal blood pressure flow gives you power. You can catch concerning changes before they cause trouble and work with your physician if lifestyle or medical steps need tweaking.
Diastolic vs. Systolic Blood Pressure: Which Matters More for Heart Health?
A study published in the Journal of General Internal Medicine reveals the most concerning blood pressure number depends on your age. For adults under 50 years old, a high diastolic blood pressure reading is a stronger predictor of early mortality than an elevated systolic reading. However, after age 50, a high systolic pressure becomes the best indicator of increased risk for premature death.
This doesn’t mean that once you pass 50, you can ignore a high diastolic reading. An elevated diastolic pressure at any age still raises your risk of developing major health issues and dying early. But based on some research, it loses its status as the most accurate mortality forecasting tool in the later years.
The takeaway? You need to monitor both your systolic and diastolic blood pressure like your life depends on it. But knowing which value matters most helps you better understand your risk profile at different stages of life. Under 50, keep a close eye on that lower diastolic value, while over 50, the upper systolic number becomes the most crucial one to control, although both are important.
Elevated Systolic Blood Pressure Becomes More Common with Age
Here’s the concern. Elevated systolic blood pressure is increasingly prevalent in older populations. Studies show that approximately two-thirds of adults over age 60 have concerningly high systolic readings. Unfortunately, some evidence suggests doctors are less aggressive about treating isolated high systolic pressures compared to high diastolic values. This discrepancy in treatment puts many older patients at higher risk for adverse events like heart attack, stroke, and premature death from heart disease.
The rise in isolated systolic hypertension later in life often relates to age-associated stiffening and loss of elasticity in the major arteries. This arterial stiffening increases resistance to blood flow, forcing the heart to work harder to pump blood through the circulatory system. The excessive workload on the heart over time leads to cardiac remodeling and dysfunction. That’s why high systolic values can be so detrimental to aging people.
We need more focus on proactively monitoring and treating elevated systolic blood pressure in older adults. Those over 50 should regularly check their systolic blood pressure and discuss readings with their doctor. Lifestyle changes, medications, or both may be warranted to get high systolic levels under control. This could significantly reduce older individuals’ risk for fatal cardiovascular events. With heightened awareness and proper management, the dangers of age-related systolic hypertension can be mitigated.
How Often Should You Check Your Blood Pressure?
For most healthy adults with normal blood pressure, checking a reading once every year or two during routine medical visits is sufficient. This establishes a baseline to compare any changes over time. More frequent monitoring such as every 3-6 months may be warranted if you have borderline or slightly elevated blood pressure readings.
If you have high blood pressure or hypertension, regular monitoring is essential. Checking your blood pressure about once a month, or even more often, is ideal for determining the impact of lifestyle changes and medications. Your doctor may want home or ambulatory blood pressure monitoring to get readings throughout the day.
People with health conditions that increase cardiovascular risks like diabetes, kidney problems, or high cholesterol need blood pressure checks more often, such as every doctor visit. Pregnant women should monitor blood pressure monthly or more. Older adults may require more frequent monitoring too, as high blood pressure becomes more common with age.
No matter your situation, talk to your doctor about the optimal frequency for you to measure your blood pressure. This allows you to catch any problematic changes early, while giving you peace of mind if levels remain in the healthy range. Consistent monitoring paired with lifestyle modifications and medications will you maintain a normal blood pressure, catch blood pressure changes early, and reduce your risk of heart disease.
Conclusion:
So don’t just nod and smile when your doc rattles off those two numbers. They’re an important peek into your heart health. And understanding them is the first step towards keeping your ticker in tip-top shape, now and in the future. Just as importantly, make sure you’re leading a heart-healthy lifestyle.
References:
- Basile JN. The Importance of Systolic Blood Pressure Elevation in Elderly Persons. Medscape. Published August 31, 2004. Accessed December 5, 2023. https://www.medscape.com/viewarticle/487959
- Taylor BC, Wilt TJ, Welch HG. Impact of diastolic and systolic blood pressure on mortality: implications for the definition of “normal”. J Gen Intern Med. 2011 Jul;26(7):685-90. doi: 10.1007/s11606-011-1660-6. Epub 2011 Mar 15. PMID: 21404131; PMCID:
- “Understanding Blood Pressure Readings | American Heart Association.” 30 May. 2023, https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings.
- “Diastole vs. Systole: Guide to Blood Pressure – Healthline.” 30 May. 2018, https://www.healthline.com/health/diastole-vs-systole.
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