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Blood Pressure & Heart Failure Risk

What is blood pressure?

Blood pressure is a measure of the force of blood against the walls of your arteries (or blood vessels) as blood flows through your body. Blood pressure is reported as two numbers. The first or top number is the systolic pressure—the pressure of the blood in the vessels as the heart beats. The second or bottom number is the diastolic pressure—the pressure in the vessels as the heart relaxes between beats. Blood pressure is measured in millimeters of mercury (mm Hg), reflecting how much the pressure in your arteries would raise a column of mercury. A blood pressure of 120 mm Hg systolic and 80 mm Hg diastolic is written 120/80 ("120 over 80").

Classification of Blood Pressure For Adults1
Category Systolic (mm Hg) Diastolic (mm Hg)
Normal Less than 120 and Less than 80
Prehypertension 120-139 or 80-89
Stage 1 High BP 140-159 or 90-99
Stage 2 High BP 160 or higher or 100 or higher

Prehypertension means that you don’t have high blood pressure yet, but are likely to develop it in the future compared with people with lower blood pressure.

High blood pressure is called "the silent killer" because it does not have any signs or symptoms. In most people, the basic causes of high blood pressure are unknown. Having your blood pressure measured is the only way to tell if you have high blood pressure. You should have your blood pressure measured at least once every 2 years, and at least once a year if you already have prehypertension. Based on your specific risk factors, your doctor may recommend that you have your blood pressure checked more often.

How does high blood pressure affect my risk of heart failure?

High blood pressure is one of the most common risk factors for developing heart failure. Nearly 75% of patients had high blood pressure before developing heart failure, according the to the National Heart, Lung, and Blood Institute.2 High blood pressure triples a woman’s risk of developing heart failure (it doubles the risk in men) and accounts for nearly 60% of heart failure cases in women (compared with 40% in men).3, 4 Even prehypertension may increase a woman’s risk of developing heart disease.5

High blood pressure makes the heart work harder to contract and pump out blood against the increased pressure in the blood vessels. In response to the increased workload, the muscle wall of the heart’s main pumping chamber (the left ventricle) becomes thicker, just as other muscles in your body grow larger the harder they work. Over time, the overworked heart muscle can stretch and weaken, damaging your heart’s ability to contract and pump blood (systolic heart failure), or it can stiffen, limiting your heart’s ability to relax and fill with blood (diastolic heart failure).

High blood pressure can also increase your risk of heart failure by causing the walls of your blood vessels to harden, leading to coronary artery disease (CAD), another major risk factor for heart failure.

Is high diastolic blood pressure related to diastolic heart failure?

Diastolic blood pressure and diastolic heart failure share the term "diastolic" because they both occur during the phase of the heart’s cycle when it relaxes and fills with blood ( diastole). High diastolic blood pressure doesn’t necessarily lead to diastolic heart failure, just as high systolic blood pressure doesn’t necessarily lead to systolic heart failure. Any type of high blood pressure places added stress on your heart, increasing your risk of developing heart failure. The type of heart failure a person develops is influenced by many factors.

Does high blood pressure affect the risk of developing heart failure differently in women?

Women with high blood pressure are more likely than men to have a thickened, but not stretched (dilated), heart muscle.6-9 Over time, the thickened heart muscle becomes stiff and the heart is unable to relax and expand to fill with enough blood, leading to diastolic heart failure.

High blood pressure is the most common cause of diastolic heart failure in women.10 African-American women have higher blood pressure numbers than do white women,4 which may explain why African-American women have thicker pumping chamber walls compared with white women.6, 7

Preventing High Blood Pressure & Heart Failure

Filed in Am I at Risk? > High Blood Pressure

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