Hypertension can raise the risk of severe health problems, including heart attacks and stroke. You can reduce those risks by managing your blood pressure and taking heart-healthy steps.

A heart attack is usually the result of plaque buildup in the coronary arteries, which narrows those blood vessels and makes it more likely for blood clots to form. High blood pressure can weaken and damage these arteries, allowing plaque to build up and reduce the steady flow of blood to the heart.

This can, in turn, lead to heart attacks.

You can lower your risk of narrowed arteries by keeping your blood pressure and cholesterol levels in healthy ranges. Managing high blood pressure usually requires a combination of healthy lifestyle behaviors and medications.

But a heart attack is still possible even while managing your blood pressure. That means it’s vital to recognize the signs and symptoms of a heart attack and know what to do if you suspect you’re having a heart attack.

Your blood pressure is a measurement of the force of circulating blood against the inside walls of your arteries. Blood pressure has two components:

  1. systolic pressure (the top number in a blood pressure reading) is the pressure in the arteries when your heart constricts and pumps blood out to the body
  2. diastolic pressure (bottom number), which is the pressure in the arteries in between heartbeats while the heart is resting

Systolic and diastolic pressures are measured in millimeters of mercury (mmHg)

  • Standard or healthy blood pressure is considered to be systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg, according to the American Heart Association.
  • Elevated blood pressure is a systolic reading between 120 and 129 mmHg and a diastolic reading between 80 and 89 mmHg.
  • Anything above those levels is high blood pressure or hypertension

Even when mild, hypertension can begin to weaken the coronary arteries, setting the stage for atherosclerosis and a heart attack. When high blood pressure is more severe, so too is the damage that can occur.

Any decrease you can achieve in moving your high blood pressure down to a natural level will help.

A 2022 study suggests that reducing blood pressure of 161/84 mmHg to 144/78 mm Hg reduced the risk of cardiovascular events, such as heart attack, by 23%.

High blood pressure can be a hereditary condition. A 2017 study suggests that as many as 40-50% of high blood pressure cases in the United States are people who inherited a predisposition for hypertension.

Other factors are also well-established causes of high blood pressure. Among them are:

  • advancing age
  • excessive alcohol consumption
  • obesity
  • sedentary lifestyle
  • smoking
  • various medical conditions, such as diabetes and kidney disease

Occasional spikes in blood pressure, brought on by stress, exercise, or some medications, are unlikely to cause coronary artery damage. However, if high blood pressure becomes chronic and goes untreated for months or years, the risk for atherosclerosis and other complications grows significantly.

The timetable for hypertensive heart disease to develop is highly individualized, as several factors can contribute to a person’s heart attack risk. Older adults, who already face an elevated risk of heart attack, may be able to withstand fewer years of uncontrolled high blood pressure than younger people.

The severity of the high blood pressure is also a major factor in determining the timeline for heart damage.

A 2019 study suggests that for people with an average systolic pressure of about 160 mmHg, the heart attack or stroke risk within 8 years was about 4.8%. The 8-year heart attack or stroke risk for people with a systolic average of 136 mmHg was 1.9%.

The bottom line is that the sooner you can get your blood pressure down to a healthy range or close to it, the lower your risk of atherosclerosis and heart attack.

Most heart attacks involve chest pain or pressure that lasts for at least a few minutes or subsides and then returns. Three other common symptoms of an impending heart attack include:

  • lightheadedness or fainting
  • pain in the jaw, neck, shoulders, or arms
  • shortness of breath

Lowering your blood pressure can sometimes be done through healthy lifestyle behaviors only, though many people also need medications to manage their blood pressure.

Some of the most significant lifestyle changes you can make to lower your blood pressure and reduce your heart attack risk include:

  • exercise at least 150 minutes a week (aim for 30 to 40 minutes most days of the week)
  • follow a heart-healthy diet, such as Mediterranean-style eating plan
  • maintain a moderate weight (consult your doctor about a realistic and target weight)
  • avoid smoking (your heart disease risks start to diminish the day you quit for good)

Your doctor may also prescribe one or more antihypertensive medications to help lower your blood pressure.

Managing high blood pressure reduces your risk of heart attack, stroke, kidney disease, and other serious health problems. Managing high cholesterol is also essential in lowering the risk of atherosclerosis, often the precursor to a heart attack.

Talk with your doctor about the steps to manage your blood pressure.