5 Reasons to Get Your Blood Pressure Checked Now

3. The "new normal" may be lower than you think

The definition of high blood pressure has changed in recent years. Before 2017, anything below 140/90 mm Hg was considered OK. Now, a blood pressure at or above 130/80 mm Hg is deemed high, according to updated guidelines from the American College of Cardiology and the American Heart Association.

"This still comes as a surprise to many patients, even though that recommendation has been in place now for nearly four years,” Erin Michos, M.D., a cardiologist and an associate professor in the Division of Cardiology at Johns Hopkins School of Medicine, said in a 2021 interview. “Many patients are still not familiar with the new targets.”

Results from a large federal study called SPRINT are a major reason for the change in guidelines. Researchers found that adults age 50 and older who brought their systolic blood pressure below 120 mm Hg significantly lowered their risk for heart attack, heart failure or stroke by 25 percent, compared with adults with a systolic blood pressure of 140 mm Hg. They also slashed their risk of death by 27 percent.

"That's huge,” said Cora Lewis, M.D., professor and chair of the Department of Epidemiology in the University of Alabama at Birmingham School of Public Health, who worked on the study. “That's people who did not die.”

In fact, the benefits of intensive blood pressure control were so obvious that the study was stopped early. However, several years of follow-up data, published in 2021 in New England Journal of Medicine, confirm the initial findings.

"The most important message is that blood pressure control is important, that blood pressure control literally saves lives,” says Mahboob Rahman, M.D., professor of medicine at Case Western Reserve University and the division chief of nephrology and hypertension at University Hospitals Cleveland Medical Center. “If you work with your doctor to control your blood pressure well, you will be at lower risk of developing heart disease; you live longer, literally.”

4. Risks are low when it comes to lowering blood pressure

Clinicians have a tendency to be more cautious when it comes to treating hypertension in older adults, who are more likely to have multiple chronic conditions and are at increased risk for falls, Michos says. (Dizziness and lightheadedness can be symptoms of blood pressure that's too low.) But recent research shows that fear is a bit unfounded.

A 2016 sub-analysis of SPRINT data revealed that intensive blood pressure control in adults 75 and older did not result in more injurious falls. It did, however, result in significantly lower rates of cardiovascular events and death.

Another finding that challenges a common concern when it comes to older adults: Aggressively treating blood pressure didn't raise participants’ risk of experiencing orthostatic hypotension — that feeling of dizziness when you go from sitting to standing because of a drop in blood pressure.

"That actually gets better when you treat blood pressure better,” Michos says. “And that might sound paradoxical, but it may be that once you just get better control of blood pressure in general, then some of the things that lead to orthostatic hypotension” also get treated, she explains.

As far as other risks go, the final report from the SPRINT trial looked at additional safety measures of intensive blood pressure control and found that conditions like electrolyte abnormalities and acute kidney injury were more common in the intensive-treatment group. However, rates of serious adverse events overall did not differ significantly between the groups.

The key to going lower with blood pressure management, Goldberg says, is to pay attention to your symptoms. “We need to reframe this: If you have a blood pressure of 110/70 and you're not dizzy or lightheaded or fainting, then that blood pressure is fine. It's not just about the number, it's about how you feel,” she says.

Your doctor can also help go over any risks related to lowering your blood pressure.

5. Lower blood pressure is a boon for the brain

Better brain health is another potential benefit of managing high blood pressure. Researchers on the SPRINT MIND study found that participants who had their systolic blood pressure controlled to 120 mm Hg had a lower incidence of mild cognitive impairment — a precursor for dementia — compared with participants in the standard (140 mm Hg) group.

"With all that in mind — the lower rate of major adverse vascular events, the reduction in stroke, the reduction of mortality, the trend for better brain health — all of this is in favor that we should be doing a better job of treating older adults with high blood pressure,” Michos says.

Make a plan with your provider — and stick with it

Making some lifestyle adjustments can have an impact on your blood pressure. For example, a small reduction in sodium can cause your blood pressure to drop by about five or six points. And a 2-pound weight loss can shave about one point from your readings, according to the Mayo Clinic.

Medication can also help, and patients shouldn't feel any shame in turning to this “tool for prevention” if it's recommended by your health care provider, Goldberg says.

The key is to “pick a goal” for your target blood pressure and then work with your doctor to get there — even if it requires a gradual approach, says the University of Alabama's Lewis. “If you do well at 140 and you want to go down to 130, OK. Do it. But let's just stop living with blood pressure that's not well controlled. Let's just not do that anymore.”