A large new study has found that lowering systolic blood pressure—the top number in a blood pressure reading—to below 120 mm Hg can greatly reduce the risk of heart attacks, strokes, and death. This is a stricter target than the commonly recommended goal of keeping blood pressure under 140 mm Hg.
The research, presented at the American Heart Association’s 2023 Scientific Sessions in Philadelphia, was led by Dr. Jing Li from the National Center for Cardiovascular Diseases in Beijing, China. The study, called the ESPRIT trial, followed over 11,000 adults in China who had high blood pressure and were considered at high risk for heart disease.
Participants were randomly split into two groups. One group received intensive treatment to bring their systolic blood pressure below 120 mm Hg. The other group received standard treatment, aiming to keep systolic pressure below 140 mm Hg.
Both groups were given blood pressure-lowering medications, but those in the intensive group took higher doses or a greater number of medications to meet the lower target.
After three years, the group with the lower blood pressure target had clearly better outcomes. They had a 12% lower risk of major heart problems, including heart attacks, strokes, and deaths from heart-related causes. They were also 39% less likely to die from heart disease and 21% less likely to die from any cause.
These results are especially important for people who are older or have had previous heart disease or stroke. In this study, the average age of participants was 64. Nearly 30% had already experienced heart disease, and 27% had previously had a stroke.
One concern about aggressively lowering blood pressure is the risk of side effects. The study did find that fainting (also called syncope) occurred slightly more often in the intensive group—about 3 out of every 1,000 patients. But this small increase in side effects was outweighed by the much larger benefits in preventing heart problems and saving lives.
Dr. Li and her team believe these findings are strong evidence that aiming for a lower blood pressure target could help people live longer and stay healthier, especially those with a high risk of heart disease. The results suggest that doctors should consider setting more ambitious blood pressure goals for their patients when it is safe to do so.
While the study was conducted in China, the results are consistent with similar research in other countries, including the well-known SPRINT trial in the United States, which also supported lower blood pressure targets for high-risk individuals.
Future research will continue to follow patients to understand the long-term effects of intensive blood pressure control. For now, this study offers hope that tighter blood pressure management could be a powerful tool in preventing heart disease and saving lives around the world.
If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and people with severe high blood pressure should reduce coffee intake.
For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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