The risk of cardiovascular disease in people with hypertension is clearly defined, but it’s still unclarity on how normal systolic blood pressure (SBP) affects the risk of atherosclerotic cardiovascular disease (ASCVD). The objective of this study is to evaluate the association of SBP levels with ASCVD in people without hypertension.

This is a cohort study that included a total of 1,457 participants (894 women, free of ASCVD, dyslipidemia, and diabetes. The participants had a healthy SBP level between 90 and 129 mm Hg. The mean age of the participants was 58.1 years, and the median follow-up was 14.5 years. The primary objective of the study was the presence of coronary artery calcium (CAC) and incident ASCVD events.

There was an increase in ASCVD risk factors and CAC with increasing SBP levels. The adjusted hazard ration (aHR) for ASCVD was 1.53 for every 100 mm Hg increase in SBP levels. In participants with SBP levels 90-99, the aHR for ASCVD was 3.00, for 100-109, it was 3.10, and for 110-119, it was 4.58.

The research concluded that the risk of ASCVD begins at SBP level 90 mm Hg, and increases positively with the increase in the SBP levels. The findings, therefore, suggested the importance of early regulation of SBP levels in controlling traditional ASCVD risk factors.