Changing the "Normal Range" for Blood Pressure from 140/90 to 130/Any Improves Risk Assessment

Area of Science:

• Cardiovascular Health
• Public Health
• Biostatistics

Background:

• The current standard for normal blood pressure (BP) is <140/90 mm Hg.
• This standard may not optimally identify individuals at increased risk of mortality.
• A re-evaluation of reference ranges is needed for improved risk stratification.

Purpose of the Study:

• To redefine the "normal" blood pressure reference range.
• To identify a threshold that more effectively predicts increased mortality risk.
• To compare the efficacy of a new range against the current <140/90 mm Hg standard.

Main Methods:

• Analysis of life insurance applicant data (2,472,706 individuals) from 1993-2007.
• Utilized Clinical Reference Laboratory (CRL) blood pressure measurements.
• Follow-up for vital status through the September 2011 Social Security Death Master File.

Main Results:

• An alternative reference range of systolic blood pressure (SBP) <130 mm Hg was evaluated.
• This range included 84% of applicants, capturing 89% of lives but only 68% of deaths compared to <140/90.
• The <130 SBP range demonstrated a lower mortality rate and narrower relative risk.

Conclusions:

• A revised "normal" reference range of SBP <130 mm Hg provides superior mortality risk assessment.
• This new range effectively identifies higher-risk individuals.
• The proposed range maintains inclusion of a substantial population segment.