You keep an eye on your blood pressure, and it’s always in the healthy range. That means you’re safe from a heart attack, right? Not necessarily. While hypertension (high blood pressure) is a well-known risk factor, it’s not the only one — heart attacks can happen even when your numbers are within a healthy range.

Keep reading to learn more about the connection between blood pressure and heart attacks — and how to protect your heart health.

Normal Blood Pressure vs. High Blood Pressure: What’s the Difference?

Cardiovascular disease (CVD), a group of conditions that affect the heart and blood vessels, can make the heart weaker and is a common cause of heart attacks. In the United States, almost 2,500 people die from CVD every day. Certain health conditions, such as obesity and high blood pressure, can increase the risk of cardiovascular disease.

Before we explore the link between blood pressure and heart attacks, let’s go over what normal and high blood pressure look like.

Blood pressure is measured using two numbers, using the measurement millimeters of mercury (mm Hg):

• Systolic pressure — The force of blood against artery walls when your heart beats
• Diastolic pressure — The force of blood against artery walls when the heart rests between beats

Here’s a breakdown of blood pressure categories:

Most healthy adults should aim for a blood pressure below stage 2 (140/90 mm Hg). But for people with (or at a high risk for) CVD, diabetes, or chronic kidney disease, the blood pressure goal should be below stage 1 (130/80 mm Hg).

The American Heart Association and the Centers for Disease Control and Prevention (CDC) state that nearly half of American adults have high blood pressure. Nearly 50 percent of adults around the world with hypertension don’t even know they have it, so many aren’t diagnosed or treated.

Hypertension is related to a higher 10-year and lifetime risk of CVD. High blood pressure puts extra strain on your heart and blood vessels, increasing your risk of heart disease and heart attacks. In general, the higher your blood pressure, the greater your heart attack risk.

Risk Factors for a Heart Attack

High blood pressure can damage the inner lining of your arteries over time. It may cause small tears in artery walls, which can, in the long term, turn into scar tissue. This tissue can trap cholesterol and other substances, leading to vessel narrowing. Hypertension can also damage existing plaques (fatty buildups), increasing the risk for blood clots. If a clot completely blocks an artery that supplies blood to the heart, it can cause a heart attack.

High blood pressure also makes the heart work harder, which can lead to heart enlargement and eventually heart failure.

While high blood pressure is a significant risk factor for heart attacks, it’s not the only one. You can have normal blood pressure and still be at risk for a heart attack due to other factors. The following are some other risk factors to keep in mind.

High Cholesterol

Having excess cholesterol is an important risk factor for heart attack. Cholesterol is a waxy substance that can build up inside your arteries, forming plaques. Over time, these plaques can narrow the arteries, slow blood flow, and increase the risk of a heart attack.

Smoking

Smoking damages your blood vessels and reduces oxygen in your blood by damaging your lungs, which can put additional stress on your heart. The risk of a heart attack increases with how long and how much someone has smoked.

Diabetes

Diabetes is another major risk factor because high glucose (blood sugar) can severely damage blood vessels over time. This increases the risk of heart disease and heart attacks.

High Body Mass

Having a higher body mass index (BMI) is linked to an increased risk of heart attack. BMI is a measure of weight in relation to height and is used to assess body size. Excess body weight can strain the heart and contribute to other risk factors, such as high blood pressure and diabetes. It can also increase inflammation in the body, which may lead to fat buildup in the arteries.

Lack of Physical Activity

Not getting enough physical activity can weaken the heart and blood vessels over time. A sedentary lifestyle is linked to higher blood pressure, higher cholesterol, and higher blood sugar levels, all of which increase the risk of a heart attack. Lack of movement can also contribute to inflammation and the buildup of fatty deposits in the arteries, making it harder for blood to flow properly.

Age

The risk of heart attack increases as you get older, but younger adults can develop heart problems, too. Research shows that even among young adults (from ages 18 to 30) with normal blood pressure, those with other risk factors have a higher chance of developing CVD. This suggests the importance of managing heart disease risk factors at any age.

Family History

Genetics can play a role in heart health. If your parents or siblings had early heart disease, your risk may be higher.

Stress

Chronic stress can contribute to high blood pressure and other heart disease risk factors.

Diet

Eating too much saturated fat, trans fat, salt, or cholesterol can raise the risk of heart disease and heart attacks. These foods can contribute to high blood pressure, high cholesterol, and inflammation, all of which strain the heart and blood vessels.

A combination of any of these factors can also increase your risk of CVD and heart attack, even with normal blood pressure. However, even slightly elevated blood pressure (prehypertension) can increase your risk of heart attack compared to those with normal blood pressure.

Steps To Reduce Your Risk of a Heart Attack

Whether you have normal or high blood pressure, there are steps you can take to reduce your risk of a heart attack.

Know Your Numbers

Regular checkups with your healthcare provider can help you keep track of your blood pressure, cholesterol, and other important health markers. You can also monitor your blood pressure at home.

Adopt a Heart-Healthy Diet

Research shows that a Mediterranean diet is linked to better heart health outcomes, including low rates of coronary heart disease, ischemic stroke, and total cardiovascular disease.

This type of diet focuses on fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit saturated fats, trans fats, and sodium (salt).

Stay Active

Health experts recommend at least 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking or swimming. Another option is 75 minutes of vigorous-intensity exercise, like running or fast cycling. These activities increase your heart rate and breathing, helping to strengthen your heart.

Talk to your healthcare provider about which exercises and intensity levels are right for you.

Maintain a Healthy Weight

Achieving a healthy weight for your body type can support heart health and reduce the risk of heart disease. Even small changes can make a difference.

Quit Smoking

If you smoke, quitting is one of the best things you can do for your heart. Ask your healthcare provider for resources to help you stop smoking for good.

Manage Stress

Find healthy ways to cope with stress, such as practicing meditation, deep breathing, or yoga or talking to a therapist.

Limit Alcohol

If you drink, do so in moderation. According to the American Heart Association, that means up to one drink per day for women and up to two drinks per day for men.

Take Medications as Prescribed

If you have high blood pressure, high cholesterol, or diabetes, take your medications exactly as directed by your healthcare provider.

Get Enough Sleep

Poor sleep has been linked to factors that increase your risk of heart disease, such as high blood pressure and inflammation. Aim for at least seven hours of sleep per night.

Talk With Your Doctor

While normal blood pressure is a good sign for your heart health, it doesn’t guarantee immunity from heart attacks. Your overall heart health depends on a combination of factors, including your blood pressure, cholesterol levels, lifestyle habits, and genetics.

If you’re concerned about your heart health, don’t hesitate to speak with your healthcare provider. They can help you understand your risk factors and develop a personalized plan to keep your heart healthy. By staying informed and taking proactive steps, you can significantly reduce your risk of a heart attack, regardless of your current blood pressure status.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 62,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you found ways to reduce your heart attack risk factors including lowering your blood pressure?Share your experience in the comments below, or start a conversation by posting on your Activities page.