High blood pressure is one of the major silent drivers of heart disease. The force of blood pushing against your artery walls creates micro-tears and injuries, making the walls leaky and allowing cholesterol particles to invade. Most people have no symptoms until serious damage is done.
What the numbers mean
Blood pressure is reported as two numbers: systolic (top) over diastolic (bottom). Systolic measures the pressure when your heart beats. Diastolic measures the pressure between beats. Both matter, but systolic is usually the bigger risk factor.
| Category | Reading | Heart disease risk |
|---|---|---|
| Normal | < 120/80 mmHg | Baseline |
| Elevated | 120–129 / < 80 mmHg | Increased |
| Stage 1 hypertension | 130–139 / 80–89 mmHg | Roughly 2x higher |
| Stage 2 hypertension | 140/90+ mmHg | More than 3x higher |
A person with Stage 1 hypertension has roughly double the risk of heart attack or stroke compared to someone with normal blood pressure. Stage 2 more than triples it.
Why high blood pressure damages arteries
Your arteries are lined with a delicate single-cell layer called the endothelium. Healthy endothelium is smooth and acts as a protective barrier. High blood pressure batters this wall, creating micro-tears that make it permeable and inflamed. Once the wall is damaged, cholesterol particles deposit faster.
This is why blood pressure and cholesterol work together to cause heart disease. High blood pressure opens the door. Cholesterol walks through it.
How to lower blood pressure
- Reduce sodium intake (under 2,300 mg/day, ideally under 1,500 mg).
- Increase potassium-rich foods (vegetables, fruits, beans).
- Exercise 150 minutes per week of moderate-intensity activity.
- Limit alcohol.
- Lose weight if overweight (especially visceral fat).
- Take medication if prescribed.
If your blood pressure is elevated or higher, lifestyle changes are the first step. If those aren't enough, or if you're already in Stage 1 or 2, medication is often necessary.
Your target
For most adults: under 130/80 mmHg. If you have existing heart disease, diabetes, or high Lp(a), tighter control (under 120/80) is better.
When to measure
Check at least once a year. If elevated, check more often. Home monitors are accurate and useful for tracking trends. Measure at the same time each day, sitting quietly for 5 minutes first.
The bottom line
Blood pressure is one of the easiest risk factors to measure and one of the most important to control. Know your number. If it's elevated, act. The damage it causes to your arteries is silent and cumulative.
Confidence in your heart health
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