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Between systolic and diastolic

Your average Joe probably doesn’t give much thought to the difference between systolic and diastolic blood pressure measurements. If you happen to be one of those Joes, here’s your chance to enjoy a quick Introduction to BP 101, courtesy of HSI Panelist Allan Spreen, M.D.

On an HSI Forum thread, a member named Rob posted this question:

“Someone mentioned that the difference between your systolic and diastolic measurements were more critical to predicting a heart attack than the BP reading alone. They went on to say that if the difference is 65 or more, you’re in for a heart attack. There are times when this difference for me is above 65 (73 was the worst). Should I get my will in order? Actually, Jenny, I was hoping you’d be able to get one of your experts to comment on this and save me from worrying myself into ulcers.”

Between systolic and diastolic, your systolic pressure (the first number in the blood pressure reading) is generally considered the more important indicator of heart health – especially for those age 50 or older. As for the importance of the difference between the two pressures, I asked Dr. Spreen to explain and here’s how he answered Rob’s question:

“What you’re talking about is called ‘pulse pressure’, or the differential between the high reading and the low one. Nothing guarantees that you’ll have (or not have) a heart attack. Many heart attacks occur with low serum levels of cholesterol, for example, so don’t head into ulcer state yet! Also, the powers-that-be are now telling us that any pressure above 120/80 up to 140/90 is ‘pre-hypertension’ and they’re even suggesting that we get started early on drug therapies, which sounds suspiciously like an attempt to bail out the drug companies to me.

“However, physiologically a high pulse pressure may indicate that the blood vessels are not as ‘elastic’ as they might be, implying that they are not in peak condition (healthy, elastic arteries stretch to handle pressure changes and therefore lower the ‘tops’ and ‘bottoms’ of big peaks). Therefore, you do want to respect pulse pressures hitting 75, not by worrying yourself into ulcers but by getting educated on actual ways to treat the situation.

“Get a serum homocysteine level and a C-reactive protein, then talk with your doc. Those are the most sensitive tests, and can give a good baseline of where you are as you take steps to improve. Then, if they indicate a problem, get started on what can fix ’emfolic acid, vitamin B-6, vitamin B-12, maybe some magnesium, vitamin C (gram doses), and a good multi withOUT iron, for a start. Then, go to and learn about IV chelation.

“That way you’ll have a proactive avenue of attack against a defeatable enemy, instead of sitting home swallowing antacids and worrying yourself to death!”

“Should You Give Up Nuts, Steak – or Both? Try Neither!” William Campbell Douglass, M.D., Real Health newsletter, 8/1/02 “Nutrients in 1 Ounce of Tree Nuts and Peanuts” USDA National Nutrient Database for Standard Reference, Release 15, August 2002,