A new study from researchers at Mass General Brigham shows that lowering high blood pressure more than usual may bring big health benefits—even if there are some side effects.
The study found that aiming for a lower blood pressure target, especially below 120 mm Hg, could help prevent heart attacks, strokes, and heart failure better than keeping it at 130 or 140 mm Hg.
The research team used a detailed computer simulation to look at how people’s health might change over their lifetime depending on how low their blood pressure is kept. They used data from trusted studies like the Systolic Blood Pressure Intervention Trial (SPRINT), the National Health and Nutrition Examination Survey (NHANES), and others.
They compared three blood pressure goals: below 120, below 130, and below 140 mm Hg. Systolic blood pressure is the top number in a blood pressure reading. It shows how much pressure your blood puts on your arteries when your heart beats.
A common healthy reading is 120/80, but doctors are still debating whether aiming lower is even better for people at high risk of heart problems.
The simulation included real-world issues like errors that happen when blood pressure is measured in a doctor’s office. Even after factoring in these mistakes, the lowest target—under 120 mm Hg—still helped prevent more serious problems than the other two targets.
However, lowering blood pressure this much also came with more side effects. These included dizziness, kidney problems, and a slower heart rate. People taking more medications needed more doctor visits too.
The researchers also looked at how much each approach would cost by measuring the cost per quality-adjusted life-year (QALY). This method looks at both how long people live and how good their quality of life is.
They found that aiming for below 120 mm Hg was cost-effective. It cost about $42,000 per QALY gained, which is considered a good value in healthcare.
Dr. Karen Smith, the lead author and a researcher at Brigham and Women’s Hospital, said that this lower target can help people who are at high risk for heart disease. She explained, “Our findings suggest the intensive <120 mm Hg target prevents more cardiovascular events and provides good value, even when measurements aren’t perfect.”
Still, she warned that not everyone should aim for such a low blood pressure. Some people may have more side effects from the medicines, and they may prefer to aim for a slightly higher target. She said that it’s important for patients and doctors to make decisions together, based on the patient’s own health and preferences.
This research gives strong support to the idea that keeping blood pressure below 120 mm Hg can help many people live longer and healthier lives. But it also reminds us that the best care is personal care.
If you want to learn more about blood pressure, there are other helpful studies. Some show that when you take blood pressure medicine during the day can matter. Others show that some drugs might actually make the condition worse in certain people.
Scientists are also working on new treatments that could change the way high blood pressure is managed in the future.
If you care about high blood pressure, please read studies about breakfast for better blood pressure management, and the gut feeling that lowers blood pressure.
For more health information, please see recent studies about how the dash diet helps lower blood pressure, and how to eat your way to healthy blood pressure.
The full study was published in the Annals of Internal Medicine.
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