High Blood Pressure: Why the Numbers aren’t as Important as We Think

As a medical doctor working in the hospital for the last 15 years, I often see patients who come to the hospital with high blood pressure and are anxious about their numbers. However, I want to make it clear that the numbers alone are not as important as we think.

In this blog post, I will explain why and how to understand the true risk of high blood pressure.

First, it’s important to understand why blood pressure is considered important. If people have persistently elevated blood pressure, there is evidence that they are at a higher risk of heart attacks and strokes over many years. If you can lower the blood pressure, it reduces that risk by about 25%. However, it’s not as straightforward as just lowering the number.

An analogy that can help understand this is to imagine visiting a construction site. You see a sign that says “people here must wear a helmet”. The reason for this is that the chances of something falling on someone’s head are high, and if they were wearing a helmet, it could reduce their risk of dying from injury by 25%. However, the chances of the roof falling on your head while you’re in your house are very low compared to if you were on a construction site. Similarly, blood pressure is just one of the factors that determine the risk of stroke or heart attack.

A study by Erika Wallace in the Heart Journal 2002, called “Cardiovascular and Coronary Risk Estimation in Hypertension Management,” demonstrated this point. The study took two patients with the same blood pressure of 150/96mm of Hg.

Patient A was young, female, had low cholesterol, was a non-smoker, and didn’t have diabetes. The risk of having a problem in ten years was incredibly low. In fact, you would have had to treat 321 people with blood pressure medications to make any difference to one person.

On the other hand, Patient B was male, much older (65), had high cholesterol, was a smoker, and was diabetic. In him, the risk of something bad happening to him over 10 years was much higher. Therefore, you only needed to treat 16 people to make a difference to one life.

This goes to show that it’s not only the blood pressure that is important, it’s all the other things such as age, cholesterol, smoking status, and diabetes, that contribute to a person’s overall risk.

In conclusion, high blood pressure is an important risk factor for heart attack and stroke, but it’s not the only one. It’s important for healthcare providers to not solely focus on blood pressure numbers, but also consider a person’s overall health and risk factors. If you’re concerned about your blood pressure, talk to your healthcare provider about your specific risk and what you can do to reduce it.

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