Systolic versus diastolic blood pressure importance
Good morning Doctor Joshi. Is it true that the systolic pressure is more important than the diastolic? In my case the diastolic number is above 80 at times but the systolic is always in the 120s or even lower.
Thanks for asking—this is a common confusion. Both systolic (top) and diastolic (bottom) matter, but systolic is the stronger predictor of heart and stroke risk, especially with age. That said, diastolic ≥80 mmHg counts as elevated if it’s persistent. What you’re describing (systolic in the 120s with diastolic creeping over 80) can be “isolated diastolic hypertension.” Evidence on its risk is mixed, but it’s not zero—so it’s worth tightening lifestyle and tracking. Practical next steps: confirm home BP correctly (seated, rested 5 minutes, arm at heart level, 2 readings morning/evening for a week), target <120–129/<80 if feasible, and focus on salt <5–6 g/day, regular exercise (150+ minutes/week), weight/waist control, good sleep, and limiting alcohol. If diastolic stays ≥80–85 repeatedly, discuss with your clinician about whether treatment is needed based on your overall risk profile.