"120 Over 80, Perfect": Why This Blood Pressure Value Isn't Ideal for Everyone, According to a Cardiologist

"120 Over 80, Perfect": Why This Blood Pressure Value Isn't Ideal for Everyone, According to a Cardiologist

You've probably heard that "120 over 80" is the perfect blood pressure. But is it really ideal for everyone? A cardiologist explains why it might not be.

High blood pressure, often called the "silent killer," is a leading cause of heart attacks and strokes, affecting about one in three adults, often without symptoms. Over time, it can damage organs like the brain, heart, kidneys, and eyes. However, the ideal blood pressure is still debated.

Blood pressure has two values: systolic (top) and diastolic (bottom). 

  • Below 120/80 mmHg as optimal
  • 120-129/80-84 mmHg as normal
  • 130-139/85-89 mmHg as high-normal
  • 140/90 mmHg or higher as high blood pressure

A recent Chinese study in the Lancet on 11,000 patients found that lowering systolic pressure below 120 mmHg reduces heart issues in high-risk patients. After 3.4 years, those with more intensive treatment had fewer cardiovascular events (9.7%) compared to those treated to maintain 140 mmHg (11.1%).

The cardiologist notes that while the results are significant, they aren't overwhelming, and side effects need consideration. Surprisingly, few side effects were reported in the intensive group, but in real practice, many patients struggle with symptoms like fatigue when their blood pressure drops too low.

For older patients, lowering blood pressure too much can cause issues. If patients experience side effects, a systolic reading around 130 mmHg is acceptable. However, values over 135 mmHg raise the risk of heart problems. 

For healthy individuals, lower blood pressure is better, as long as it doesn't cause symptoms. Those with naturally lower readings, like 100/60, are at lower risk for heart problems compared to someone with 120/80.

As we age, our blood vessels lose elasticity, raising blood pressure. For people aged 18 to 65, treatment is recommended when readings hit 140/90 mmHg or higher. For those over 80, treatment is usually started at 160/90 mmHg if they are in good health.

To lower blood pressure, experts recommend regular exercise like cycling, walking, or swimming, a healthy diet, and maintaining a healthy weight. Medications may be necessary for some and should be taken consistently if prescribed.