For decades, 120 mm Hg has been considered the normal upper limit for adult systolic blood pressure (SBP). Practice guidelines have long referred to this threshold for classifying ranges of blood pressure (BP) elevation and treatment targets, given the consistent epidemiologic finding that cardiovascular disease (CVD) risk is continuously increased from the SBP level of 120 mm Hg and upwards. Amid previous studies using outcomes associations to determine a normal SBP range, there remain limited data on potential sex differences. It is well known that BP levels in adulthood are on average lower in women than men in the healthy state; however, whether or not a lower range of SBP might be considered normal for women versus men is unclear. Expanding from previous reports of basal SBP values existing within a lower normal range for women than for men, our results indicate that CVD risk is associated with elevations from lower SBP ranges in women compared with men.
