The research looks at the first number, systolic blood pressure, which indicates how much pressure your blood is creating against artery walls when the heart beats.
While less than 120 millimeters per mercury may be within the normal range for men, the target systolic blood pressure for women should be less than 110 millimeters per mercury, the study found.
“We have been thinking about what normal blood pressure is in people, assuming that men and women are the same, when in fact they are much more different than we think,” said Cheng, who also serves as an associate professor of cardiology at Cedars-Sinai .
The study examined blood pressure measurements of just over 27,000 participants. The results revealed that, for women, levels above 110 millimeters per mercury were associated with the risk of developing any type of cardiovascular disease – including heart attack, heart failure and stroke – a difference from the results of the report for men.
The implications are far-reaching. Blood pressure is, as Cheng said, “the most important modifiable risk factor for all different types of cardiovascular disease”.
Although high blood pressure can bring many health risks, it is also something that people can control through diet and exercise, especially when they are younger.
Other factors, such as age, sex and genetics, are not “modifiable,” said Cheng. And considering the other modifiable factors, like high cholesterol and smoking, blood pressure is a “really we should still be doing a much better job of preventive control,” she added.
Recommendations for women
But Cheng said it is not necessarily a good thing that healthcare does not customize this number based on the patient’s gender.
Combining the importance of blood pressure with the possibility that many women can be above their true health range without them or even their doctors being fully aware of it, Cheng recommends that doctors and patients reexamine this area of health.
“Women really need to take their blood pressure seriously,” she said. “Even when it looks like it’s in the normal range for everyone – or really for men – even when it’s below 120, if it’s over 110 it’s something to keep an eye on.”
A step towards more personalized medicine
These results are a good start to what needs to be a deeper dive into other differences based on sex, said Dr. Eugene Yang, a professor of medicine at the University of Washington, who was not involved in the study.
“Due to the observational nature of this and other prominent studies, we must adhere to the published guidelines for blood pressure targets for women and men,” said Yang, who is also president of the Cardiovascular Disease Prevention Section of the American College of Cardiology.
“We need to remain open to the idea that this may not be ideal based on sex. As more studies are published, I predict that sex-specific differences in the definitions and treatment of high blood pressure may arise.”
Cheng said his team’s research on blood pressure and gender differences is just the tip of the iceberg of a much larger goal in the health field: personalized medicine.
“When we want to (reach) the holy grail of personalized medicine, we really must start with the first branching point of what makes us different – which is sex,” she said.
There needs to be a broader look at medicine, in addition to the “one size fits all” approach to most risk factor management, Yang said. And this is not just limited to differences based on sex.
“In addition, we need to be aware of racial differences and enrich the studies with sufficient diversity to assess results based on race,” he said.
Yang warned that high blood pressure is a “silent killer” and, without taking the test, someone may not know that their levels are high.
“As this is cardiac awareness month, it is a good time for everyone to ‘know their number’ and make sure they see their doctor and check their blood pressure regularly,” said Yang.