Even Mildly High Blood Pressure Ups Stroke Risk, Significantly

Filed Under: Stroke, Blood Pressure Webinar
Last Reviewed 01/15/2016

Even Mildly High Blood Pressure  Ups Stroke Risk, Significantly

Research shows that having "textbook" blood pressure readings no longer keeps you out of the danger zone. Here's why.

High blood pressure can lead to poor heart, kidney, and eye health and increase your chances of having a stroke. Plus, the latest research shows that even mildly elevated blood pressure puts you in the stroke risk category.

The American Heart Association, which sets the standard on blood pressure, has revised their blood pressure categories. Even I was shocked when they determined that  120/80 mmHg is no longer considered to be in "normal" range. You see, when I started out in cardiology decades ago 120/80 mmHg was the gold standard. It was the "textbook" blood pressure we all wanted to strive to achieve.  It was considered the "mean" point of the normal range, which was then 100-140/70-90 mmHg.

We used the term "borderline hypertension"  when the numbers started creeping up into the highest point of the normal range. So, I realize that it may be big news to many of you that there are now five blood pressure categories, and the concern starts at lower levels than before. Specifically, let's look at the latest investigation on pre-hypertension.

Research Shows Pre-Hypertension Is Riskier Than Any of Us Imagined

Researchers at Southern Medical University in China examined results from 19 previous research studies on stroke risk and hypertension. What they found is that those with even slightly high blood pressure (120/80 mmHg) were at a 66% greater risk of having a stroke compared to those in the normal blood pressure range.

This was true regardless of other stroke risk factors, such as smoking and diabetes. What’s also important is the higher the blood pressure, the higher the stroke risk. Those individuals at the high end of pre-hypertensive—meaning they had a blood pressure over 130/85 mmHg—had a 95% higher stroke risk than those with normal blood pressure.

Get more of Dr. Sinatra's advice on Healthy Blood Pressure

While an earlier study found there to be no increased stroke risk in the low pre-hypertension range, these researchers cast a wider net to reduce confounding factors, and analyzed many earlier findings. Their conclusions now enforce their recommendation that those with even mild pre-hypertension make lifestyle changes for better health—which is something I covered extensively in my webinar. I agree that it's always better to err on the side of caution and prevention.

So, the takeaway message for all of us is that we do need to watch our blood pressure levels carefully, and start taking stroke prevention measures early. To me, this is even more important if you have other stroke risk factors  like a family history and atrial fibrillation, even if the statistics based on this one meta-analysis reports pre-hypertension as an independent risk factor at this time. It only makes good sense.

What About High Blood Pressure and Salt Intake?

Before I give you my bullet list of action points on stroke prevention, I'd like to discuss salt. Salt restriction has been a mainstay recommendation for anyone with high blood pressure for decades. Salt is sodium chloride, and both sodium and chloride are key electrolytes in the body. But a few recent studies suggest that there may be a sweet spot for salt intake, and it often takes juggling by both the patient and physician to get it right.  As with most things, no one size fits all.  

While I agree that most folks should limit sodium intake to less than 2,000 mg a day, that's not the case if you have heart failure. Salt does promote water retention, which can lead to high blood pressure. But if you are have congestive heart failure along with your hypertension, I'm a little more relaxed with salt because lower sodium levels may have the potential to cause harm.

Excessive salt restriction can precipitate dangerously high renin levels. Renin is a hormone secreted by the kidney that's involved in the renin-angiotensin hormonal system that regulates water and blood pressure balance. High levels cause the renal arteries to tighten up and constrict, resisting blood flow and elevating blood pressure.

Salt is also a volume expander, so we need enough to get better blood flow through the kidneys. We are still learning the health consequences of long term salt restriction, so if you have heart failure work with your doctor to monitor your lab results and your blood pressure to maintain healthy renal function. 

What Should You Do If Your Blood Pressure Is Creeping Up?

  • Watch your salt intake. Reduce it to about 2.8 grams daily if you're generally healthy. If you have heart failure, get 2,500 mg a day to maintain sodium levels under your doctor's supervision.
  • Exercise. Studies show that moderate exercise—such as walking, dancing, or golf—can reduce blood pressure levels significantly.
  • Eat garlic. Garlic acts as a natural ACE inhibitor, helping to lower high blood pressure. Strive for a clove a day.
  • Take an omega-3 oil (1-2 grams daily) such as squid or fish oil.

Now it’s your turn: Have you tried any of these steps to lower high blood pressure?

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DISCLAIMER: The content of DrSinatra.com is offered on an informational basis only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified health provider before making any adjustment to a medication or treatment you are currently using, and/or starting any new medication or treatment. All recommendations are "generally informational" and not specifically applicable to any individual's medical problems, concerns and/or needs.

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