In older adults without heart disease, high pressure in the main artery leading from the heart is more strongly linked to early artery plaque than high blood pressure measured at the arm.

For men in their 40s and 50s, having higher top-number blood pressure is linked to faster buildup in neck artery walls over four years, even if other risks are accounted for — suggesting that high systolic pressure matters a lot for early heart disease.

In middle-aged guys, how high the bottom number of your blood pressure is doesn’t seem to matter much for early artery thickening over four years—especially once you account for the top number, which might be more important.

For middle-aged guys, how hard your blood pushes between heartbeats might show early signs of artery hardening — even if other blood pressure numbers are accounted for.