A new study from Mass General Brigham shows that bringing blood pressure down to lower levels may help prevent serious health problems, even if it means using more medication.
The study looked at how aiming for stricter blood pressure goals could affect people’s health over their lifetime.
It found that lowering systolic blood pressure to below 120 mm Hg can reduce the risk of heart attacks, strokes, and heart failure better than higher targets like 130 mm Hg or 140 mm Hg.
This research used computer models based on data from large studies like the Systolic Blood Pressure Intervention Trial (SPRINT), the National Health and Nutrition Examination Survey (NHANES), and other sources. These models helped scientists understand what might happen if patients followed different blood pressure targets.
The study also looked at side effects from medications and added real-life challenges, like errors that can happen when doctors or nurses measure blood pressure during routine visits.
Even when these errors were taken into account, aiming for less than 120 mm Hg still showed better results in preventing heart-related problems. However, the lower target came with some trade-offs.
People treated more intensively were more likely to have side effects from their medications, including feeling dizzy or faint, having kidney problems, or experiencing a very slow heart rate. The study also found that health care costs increased because these patients needed more medications and more check-ups with their doctors.
To understand if the extra effort and cost were worth it, researchers looked at a measure called “quality-adjusted life-years,” which combines how long and how well people live. They found that the lower target was still cost-effective.
It added more healthy years at a cost of about $42,000 per life-year gained, which is considered a reasonable value in the health care world.
Dr. Karen Smith, the lead author of the study, explained that these findings should encourage doctors and patients to consider aiming for lower blood pressure, especially in people who are at high risk for heart disease.
She noted that while lower targets do carry a higher risk of side effects, they also offer more protection against life-threatening conditions.
However, she also warned that this approach might not be right for everyone. The study looks at what works best on average across a large group of people.
Individual patients might have different needs or health conditions, and some may not tolerate intensive blood pressure treatments well. That’s why it’s important for doctors and patients to talk together and make decisions that fit each person’s situation.
In conclusion, this study shows that aiming for a lower blood pressure target—under 120 mm Hg—can lead to fewer heart problems and more healthy years of life, even though it may come with side effects and higher health care costs.
For many patients, the benefits may outweigh the risks, but it’s a decision that needs to be made carefully, with input from both patients and their doctors.
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