I measured my bp today at 117/78. I am wondering if the bottom number needs to be lower to be more healthy. For example 60 is more healthy that 117/70 or 117/70 is more healthy than 117/80. -or- is everything below 120/80 just as healthy. Any info? :wave:

My understanding is the older you are the lower the bottom number. I can vouch for that as I am now 46 and my lower number hangs around low 70's sometimes even in the upper 60's.

Are there any specific things I can do to get the bottom # (heart at rest) down?

riley,

There is no evidence that a diastolic of 60 is healthier than 70. There MIGHT be some evidence that 70 is healthier than 80. BUT that is a NATIVE 70, not a medicated one.
An UNMEDICATED 80 is probably FAR healthier than a MEDICATED 70.

In fact, as far as risk factors for hypertension go, one is considered a hypertensive if he is taking antihypertensive medication, no matter WHAT the numbers achieved.

So Lenin, that would mean that although you may have your blood pressure very under control, it still isn't good that you have to medicate to get it down? So an unmedicated person with the same bp will do better?
My systolic is bad without meds. but my diastolic is always fine. With meds it's very often in the 60's.
The odd thing is that most of the time my pressure is fine at the docs but high sometimes when I take it at the drugstore, etc.
Oh well you just do the best you can I guess. They are checking my kidneys to see if there is a blockage to determine why I need so many meds to keep it down. I do have some diabetes connected kidney problems.

[QUOTE=Cher2005]So Lenin, that would mean that although you may have your blood pressure very under control, it still isn't good that you have to medicate to get it down? So an unmedicated person with the same bp will do better?
[QUOTE]

Absolutely true. An unmedicated 120/80 is FAR less of a risk factor of then a 120/80 achieved with antihypertensive medication. In fact, an unmedicated 135/85 is probably less risky than a medicated 120/80.
Drug companies and doctors don't like to trumpet that fact too loudly though.:jester:

[QUOTE=Cher2005]So Lenin, that would mean that although you may have your blood pressure very under control, it still isn't good that you have to medicate to get it down? So an unmedicated person with the same bp will do better?
[QUOTE]

Absolutely true. An unmedicated 120/80 is FAR less of a risk factor of then a 120/80 achieved with antihypertensive medication. In fact, an unmedicated 135/85 is probably less risky than a medicated 120/80.
Drug companies and doctors don't like to trumpet that fact too loudly though.:jester:

Lenin,

You didn't tell me about that before :D. I guess I didn't ask the right question to get the answer I need. So can you give me some more information please. Are you saying that unmedicated 140/90 is better than medicated 120/80?
Thanks,
Michael

I know that Lenin is very knowledgable but it seems funny to think that an unmedicated number that is higher is better. Maybe the medicines take a toll on your body? Why wouldn't the lower numbers be healthier?
So it is far better to lose weight and exercise and maybe just take a diuretic than to take three meds and get the same results. Actually that does make sense said that way.

High blood pressure is often a sign of one or more disorders that don't go away when bp is controlled through medication. So risks remain when it comes to heart attacks and strokes. Control of bp more reliably fends off kidney damage and an enlarged heart--both real dangers of long-term hbp.

That apparent paradox does seem VERY strange but it's real. I cannot lay my hands on the couple places I've seen it spelled out...one was the NIH.

Michael,
Your example is close. Probably an UNTREATED systolic of 140 is a very similar risk to a treated 120...at least according to the chart I am looking for.
Have you ever wondered why all risk calculation charts tell you to count a point if you are hypertensive OR take BP meds...the risk seemingly never goes away. Treated or utreated, whatever it is, the risk remains.

Anyhoo,
Onto the very specific question of the ideal lower number (diastolic), here's another eye opener from the AMA archives:

L. W. McCloskey, B. M. Psaty, T. D. Koepsell and G. N. Aagaard
Department of Epidemiology, University of Washington, Seattle.

To examine the association between the level of treated blood pressure and the incidence of myocardial infarction, we conducted a population-based case-control study of 912 members of a health maintenance organization who were receiving standard clinical treatment for hypertension. We found a J-shaped relationship between the most recently measured diastolic blood pressure and the risk of myocardial infarction, the lowest risk occurring at 84 mm Hg. The relative risk of myocardial infarction at 60 mm Hg was 2.07 (95% confidence interval, 0.86 to 5.01), and at 100 mm Hg, 1.45 (95% confidence interval, 1.02 to 2.06). We conclude that the optimum target range for diastolic blood pressure in hypertensive patients may be 84 to 90 mm Hg. Levels outside this range may be associated with increased risk of myocardial infarction.

This would seem to throw some water on the "lower is better" school. Notice that the risk at 60 mm/Hg was higher than at 100 mm/Hg.:dizzy:

All this goes to show why I insist that 140/90 is "good enough" and that doctors that try to medicate these levels are NOT doing the patients a favor.

<I'll be back with that treated vs. untreated systolic data when I find it again.>

Another tangential report in the AHA, full article at: http://hyper.ahajournals.org/cgi/content/full/34/6/1181showed pretty clearly that in regards to STROKE specifically for the elderly:
"The risk of stroke in elderly hypertensives seems lowest at blood pressure levels of 140/80 mm Hg. In view of current evidence, cautious reduction of blood pressure in elderly individuals is recommended."
That seems yet another reason not to treat even systolic too aggresively in those of a "tender" age.

Lenin it is beginning to make perfect sense actually. Even though I keep my diabetes under extremely tight control. my eye problems and now kidney problems continue to progress. I never understood this as I thought that once it was controlled, how could that happen? But it is another case of medicated control, not natural. Who knows if all these meds. aren't a major problem? Ah but sometimes you don't have a choice.