A recent study has revealed that lowering systolic blood pressure—the top number in a blood pressure reading—to less than 120 mm Hg can significantly reduce the risk of heart disease and stroke. This strategy is more effective than the standard target of keeping blood pressure under 140 mm Hg, particularly for people at high risk of heart problems.
These findings were presented at the American Heart Association’s 2023 Scientific Sessions in Philadelphia, highlighting the latest breakthroughs in cardiovascular health. The research was led by Dr. Jing Li from the National Center for Cardiovascular Diseases in Beijing, China.
The results suggest that aiming for a lower blood pressure target in people with normal or mildly reduced kidney function can prevent major heart issues, even if they have diabetes or a history of stroke.
The study, called the ESPRIT trial, included over 11,000 adults in China who had high blood pressure and were at risk of heart disease. The participants were divided into two groups.
One group aimed to reduce their systolic blood pressure to below 120 mm Hg—this was called the intensive treatment group. The other group aimed for a more traditional target of below 140 mm Hg, known as the standard treatment group.
Both groups received medications to help lower their blood pressure, but the intensive group received higher doses and sometimes more types of medication. This was done to reach the more ambitious target of 120 mm Hg.
The results, measured after three years, were striking. People in the intensive treatment group saw much better health outcomes compared to those in the standard group. The key findings were:
- A 12% reduction in the risk of heart attack, stroke, heart-related death, and hospital visits for heart failure.
- A 39% reduction in deaths from heart-related causes.
- A 21% reduction in deaths from any cause.
These numbers suggest that lowering blood pressure to 120 mm Hg not only reduces the chance of heart problems but also helps people live longer.
The study also explored the safety of this more aggressive treatment approach. Some side effects, like fainting (known as syncope), were slightly more common in the intensive treatment group. About 3 out of every 1,000 patients experienced this issue. However, the overall benefits of preventing more heart attacks and deaths far outweighed the risks.
Dr. Li emphasized that the results provide strong proof that aiming for a systolic blood pressure of less than 120 mm Hg is both safe and beneficial for people at high risk of heart disease. He believes that using this approach worldwide could save many lives and significantly reduce the impact of heart disease.
The participants in the trial were, on average, 64 years old. About 30% of them had already experienced heart disease, and 27% had suffered a stroke before joining the study. This shows that even people with a history of serious health problems can benefit from better blood pressure control.
Although the ESPRIT trial was conducted in China, its findings match those from similar studies in other countries, suggesting that this treatment method could work well around the world. Researchers plan to continue studying this approach to understand its long-term benefits.
These findings mark a promising shift in how doctors may manage high blood pressure in the future, aiming for even lower targets to keep hearts healthier and save more lives.
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