What Your Blood Pressure Reading Can Tell Us About Your Arteries

You may focus solely on the two numbers when your blood pressure is taken at your primary care, physician’s office, or elsewhere. And they are undoubtedly essential in understanding if you have hypertension or high blood pressure. The upper number, or systolic reading, is normal at around 120 mm Hg or lower. The lower number, or diastolic reading, is normal at about 80 mm Hg or lower. When someone tells you they have 120/80, it’s just about perfect. However, blood pressure comes in ranges, and what is ideal for one person may be slightly different for someone else. Before we continue, it is important to understand what the readings mean and how to use them for diagnosing arterial issues.

The upper, or systolic reading, describes the pressure against the artery walls when the heart is actively in a contraction or pumping state. By measuring this number, we know exactly how much the heart needs to push, and the higher number can be due to several issues. For example, blood pressure can be influenced by our emotions and feelings. It’s one of the reasons why we often take multiple blood pressure readings when you come into the office. You might be flustered from bad traffic or nervous about seeing your doctor.

The lower number is the pressure against the same arterial walls when the heart is relaxed between beats. This is why the number drops so significantly. However, the question often asked is – shouldn’t the blood pressure go to zero between beats? The answer is relatively simple and lies in the fact that the arteries are elastic. They accommodate this significant pressure by bowing outwards between heartbeats; the arteries then snap back to their original state and, in doing so, maintain some blood pressure. This is essential to ensure that the heart can receive and ultimately pump the requisite amount of blood – about 5 liters every minute.

So, What Can We Learn From These Numbers?

The difference between the systolic and diastolic blood pressure numbers is the pulse pressure. It can be instrumental in telling us more about the potential for arterial diseases like atherosclerosis. From our ideal readings above, 40 is an excellent pulse pressure reading. If we plot your pulse pressure over time and the gap increases (assuming all the readings are accurate), this may signal that the arteries are not snapping back quite as well as they used to. In other words, the arteries may be hardening.

Why Do the Arteries Harden?

There are two leading causes of arterial hardening. First is something none of us can avoid: the aging process. As we age, our bodily functions diminish; the same is true for our arteries. There is an inevitable march toward hardening, which you must manage as a patient, just as we do as cardiologists. More concerning is the concept of arterial hardening due to atherosclerosis. Atherosclerosis is where excess fat in the blood, known as cholesterol, begins to build up on the sides of the arteries. This is typically a result of a sedentary lifestyle and poor diet, two issues becoming increasingly prevalent in American society. With time, these plaques go from relatively soft, to calcified and hard, taking arterial health down with it.

How Do We Manage This?

The goal is to prevent atherosclerosis in the first place, so it is never too late to improve your diet and exercise plan. Even if you have been diagnosed with heart disease, you shouldn’t rely solely on medication or procedural interventions to deal with hardened arteries. Change your lifestyle, too! That said, if you are at higher risk of heart disease, it is essential that you visit your cardiologist regularly for advice and screening. The chance of cardiovascular disease increases if you pursue less-than-ideal lifestyle choices, like poor diet, exercise, or smoking. A family history of heart disease is also a strong indicator of potential cardiovascular problems and atherosclerosis.

Procedural and medical therapies should always be considered when appropriate to avoid worsening these conditions. For example, balloon angioplasty with stenting is often an excellent first step for many patients. An atherectomy for hardened artery plaque may also be relevant in later-stage atherosclerosis. Medical therapy typically includes anticoagulants or blood thinners to let the blood pass faster.

Above all else, the first step is always a proper diagnosis. Call us to schedule time with one of our cardiologists to learn more about your condition and how it is best treated.