What Happens to Blood Pressure During a Heart Attack?

Medically reviewed by Jeffrey S. Lander, MD

Blood pressure readings during a heart attack can vary. Blood pressure could be normal, elevated, or low, depending on the affected heart area.

For example, a heart attack affecting the lower right part of the heart (an inferior wall heart attack) may cause low blood pressure. Conversely, atherosclerosis, a process where fat and cholesterol can build up in the blood vessels over time and cause them to be less flexible, can cause blood pressure to rise and remain high during a heart attack. However, there are other causes for normal, elevated, or low blood pressure during a heart attack.

This article describes what happens to blood pressure during a heart attack, how to check your blood pressure, and treatment options and lifestyle changes to keep your blood pressure in check.

Related: Systolic vs. Diastolic Blood Pressure

What Does Blood Pressure Do During a Heart Attack?

Blood pressure readings during a heart attack can vary. Depending on the heart area affected by a heart attack, blood pressure could be expected, elevated, or low. Here are some examples:

• Normal: It is possible for blood pressure to remain normal during a heart attack. An example of this is a silent, or 'mini,' heart attack, where the heart attack occurs without the classic symptoms of chest pain or pressure, sudden shortness of breath, dizziness, or sweating.

• Elevated: Blood pressure is primarily managed in the body by the endocrine system and the nervous system. Pain or anxiety can stimulate the nervous system; pain and anxiety can also cause the endocrine system to release hormones, which can induce 'fight or flight.' Both of these can occur with a heart attack, and both can cause blood pressure to rise.

• Low: When the lower right part of the heart blood vessels become blocked, referred to as an inferior wall heart attack, the blood pressure might become low. Low blood pressure can occur in an inferior wall heart attack because there is impairment to the heart's ability to move blood out of the heart to the body effectively.

Your blood pressure during a heart attack is not limited to these examples. There are various reasons your blood pressure may be normal, elevated, or low during a heart attack. Work with a healthcare provider to understand your risk for a heart attack and recognize any warning signs.

Can Blood Pressure Tell You About Heart Attack Risk?

Healthcare providers categorize your blood pressure into four different categories to help them assess your risk for heart-related events. The higher your blood pressure, the higher your risk for a heart attack.

In 2017, the American College of Cardiology (ACC) and American Heart Association (AHA) determined that systolic blood pressure (the top number of a blood pressure reading) should be below 120 millimeters of mercury (mm Hg) and diastolic blood pressure (the bottom number) should be below 80 mm Hg to help reduce the risk for heart attack and stroke.

The chart below outlines the four categories, blood pressure ranges, and interventions a healthcare provider will recommend for each risk level.

If you have elevated blood pressure or hypertension, a healthcare provider will encourage you to follow a heart-healthy diet, incorporate moderate exercise, and, depending on how high your blood pressure is, prescribe you blood pressure medication to help reduce your cardiovascular risk.

High Blood Pressure and Chest Pain: What to Know

A blood pressure reading of 180/120 mm Hg, especially if it happens suddenly, is considered severe and requires immediate medical attention. If your blood pressure is 180/120 mm Hg or higher, and you have the following symptoms, it could be an indication of an impending cardiovascular event, such as a heart attack:

• Chest pain

• Shortness of breath

• Back pain, particularly upper back between the shoulder blades

• Numbness or weakness

• Vision changes

• Difficulty speaking

If this happensto you or someone you know, call 911 for emergency medical response.

How to Measure Your Blood Pressure

If you have a blood pressure cuff at home, here are some things to keep in mind when you monitoring your blood pressure:

• Take readings at the same time every day

• Sit and rest for five minutes before checking your blood pressure

• Tighten the cuff around your bare arm (not over clothes)

• Sit still, with your back supported and your feet flat on the floor

• Make sure your arm is supported and is at chest height

• Take two readings, one minute apart, and record the readings daily to track your blood pressure over time

Related:

Ideal Blood Pressure Ranges in Females and Males

Men tend to experience hypertension more often than women until age 50 or later. Based on the ACC and AHA recommendations, blood pressure ranges are the same for men and women, at less than 120/80 mm Hg.

Treatment options for managing high blood pressure are generally the same for men and women. Aside from special consideration for people diagnosed with high blood pressure during pregnancy (preeclampsia), there are no treatment differences based on gender alone.

Heart Attack Symptoms for Women

Women, like men, often experience chest pain or pressure as a sign of a heart attack. However, women might experience different symptoms than men, including nausea, vomiting, or jaw pain. Seek medical attention if you experience any of these symptoms.

How to Lower Risk of Heart Attack and Heart Disease

High blood pressure does not always show signs of the damage it causes to blood vessels and organs, which is why it is known as the 'silent killer.' There is no cure for high blood pressure, but identifying it early, making healthy lifestyle changes, and taking blood pressure medications as prescribed can reduce the long-term effects of high blood pressure.

Lifestyle changes that reduce the adverse effects of high blood pressure include:

• Eating a heart-healthy diet that has low or no salt added

• Limiting alcohol

• Participating in moderate exercise, like walking, for at least 150 minutes weekly

• Managing stress

• Maintaining a healthy weight

• Avoiding tobacco products

• Taking all medications as prescribed

• Working with a healthcare provider to manage the condition
  

Summary

Blood pressure can be affected by a heart attack. Low blood pressure during a heart attack may occur when the blood vessels of the lower right side of the heart are blocked. During a heart attack, high blood pressure may occur when the heart's blood vessels become atherosclerotic (hardened due to fat and cholesterol build-up). For the silent, or 'mini,' heart attacks, which is where heart attack symptoms are so subtle that it might not be considered a heart attack, blood pressure often remains in the normal range.

Ensuring a heart-healthy lifestyle—which includes regular physical activity, managing stress, and a heart-healthy diet—can help ensure blood pressure remains in the normal range and minimize the risk of a heart attack.

Read the original article on Verywell Health.