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High Blood Pressure

Blood pressure

07/21/2005

Question:

Thank you for answering my questions,but I have follow up questions.1. If pulse pressure (systoic-diastolic) upper normal limits are 50, what are lower normal limits in men > 50 years of age as well as < 50? Why endurance athletes have (8) significantly higher diastolic blood pressure than normal control group (74 vs 66) if exercise lowers both diastolic and systolic blood pressures? 3.Do aerobic endurance exercises lower resting BP pulse pressures and approximately by how many points? 4.Is it with pulse pressure as with BP the lower the better but without the symptoms?5.Which BP is better(healthier) for middle age man to have:120/60 or 105/75? 6. Is having BP 100/80 better than 105/75 (for a healthy male person of 50 years of age and above to have)?Thank you

Answer:

The lower limits for pulse pressure have not been systematically studied.  Low pulse pressure is usually not a clinical problem, and differences in risk between individuals in the low ranges are small and difficult to analyze.  In people under age 50, an elevated diastolic pressure is associated with cardiovascular risk, while over age 50 the diastolic pressure becomes inversely related to risk (because of the ever increasing importance of pulse pressure).

Systolic blood pressure rises with age in the whole population.  Therefore, the majority of hypertensive people are over age 50.  In that age group, systolic hypertension makes up over of 90% of forms of hypertension, and diastolic hypertension becomes unusual.

It has been shown that exercise lowers resting blood pressure.  It is likely that exercise also lowers pulse pressure, but that effect takes longer and has not been well studied.  It is not possible to predict by how much the systolic pressure or the pulse pressure can decrease with exercise;  there are not enough data, and exercise would have to be precisely quantified, which is difficult.

The published data bases do not include individuals with a systolic of less than 115.  To distinguish the risk carried by a blood pressure of 100/80 versus 105/75 is almost impossible.  Both are excellent for a man of 50.  Theoretically, 100/80 is better, because it represents a lower systolic and a smaller pulse pressure.  In the same way, 120/60 is not as good as 105/75.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati