People in their thirties and forties with “normal” blood pressure readings may still be at significant risk for heart-related conditions, according to new research. The British Heart Foundation (BHF) has highlighted that individuals in this age group could be “quietly damaging the heart” without realizing it, potentially leading to heart attacks or strokes later in life.
A study funded by the BHF and published in the journal Circulation: Cardiovascular Imaging involved over 450 participants from University College London (UCL). The researchers found that those with higher blood pressure readings—classified as “normal but high”—could experience reduced blood flow to the heart muscle as they age, particularly by the time they reach 77 years old.
The study revealed a concerning trend: the longer individuals maintain elevated blood pressure, the greater the reduction in heart blood flow. Specifically, the risk of heart-related complications increased from as early as age 36, even when blood pressure levels did not meet the current definition of “high” blood pressure.
Dr. Gaby Captur, an associate professor at UCL and consultant cardiologist at the Royal Free London NHS Foundation Trust, emphasized the implications of these findings. “Small, steady increases in blood pressure through adulthood, even if you have a ‘normal but high’ reading, can be quietly damaging the heart, long before symptoms appear,” she stated. “Your blood pressure in your thirties, we found, can affect the heart 40 years later.”
The research tracked blood pressure readings at multiple ages—36, 43, 53, 62, 69, and 77 years. The results indicated that higher blood pressure at any of these stages was linked to poorer blood flow to the heart muscle by age 77. Notably, each 10-point increase in systolic blood pressure—such as from 120 to 130 mmHg—between the ages of 36 and 69 corresponded to up to a six percent reduction in heart blood flow at age 77.
The most significant impact occurred during a critical period between the ages of 43 and 63, when systolic blood pressure rose from 120 to 140 mmHg. Here, each 10-point increase was associated with a nine to twelve percent reduction in blood flow to the heart at age 77. Alarmingly, every one percent reduction in heart blood flow was linked to a three percent increased risk of a major cardiac event, including heart attack or stroke.
Part of the challenge lies in the classification of blood pressure. A systolic reading between 120 and 140 mmHg is often considered “pre-hypertension,” which may not prompt immediate medical intervention. Currently, health guidelines recommend starting treatment for high blood pressure only when systolic readings exceed 140 mmHg, or 130 mmHg for those with pre-existing cardiovascular conditions.
Professor Bryan Williams, chief scientific and medical officer at the BHF, stressed the importance of awareness regarding blood pressure. He described it as a “silent killer,” noting it is a leading cause of heart attacks, strokes, and premature death in the UK each year. “The reason we refer to blood pressure as the silent killer is that it is usually symptomless and blood pressure levels creep up gradually,” he explained. “The only way of being sure you don’t have high blood pressure is to get it checked.”
Given the findings, the BHF advocates for regular blood pressure checks starting at a younger age, suggesting that early intervention may prove beneficial. “This interesting research suggests that we should be encouraging people to get regular blood pressure checks from a younger age, when it is often much easier to control,” Professor Williams added.
Individuals with concerns about their blood pressure are encouraged to consult their general practitioner for advice and possible evaluation. Regular monitoring could be crucial in mitigating the long-term risks associated with elevated blood pressure readings.
