Heart disease remains one of the leading causes of death around the world, and high blood pressure plays a major role in driving this risk. Blood pressure is the force of blood pushing against the walls of the arteries.
When this pressure stays too high for too long, it puts constant strain on the heart and blood vessels.
Over time, this strain can damage the arteries, weaken the heart, and greatly increase the risk of heart attacks, strokes, heart failure, and early death.
For many years, doctors have followed general guidelines that aim to keep systolic blood pressure, the top number in a blood pressure reading, below 140 millimeters of mercury, also known as mm Hg.
This target has helped reduce heart problems for many people.
However, scientists have continued to ask an important question. Could lowering blood pressure even more provide greater protection, especially for people who already face a high risk of heart disease?
A large new study suggests that the answer may be yes. Researchers found that closely managing blood pressure and aiming for a much lower target can significantly reduce the risk of serious heart-related problems and even lower the chance of death.
The research, called the Effective Systolic Pressure Reduction Intervention Trial, or ESPRIT, was carried out in China. The study focused on people who were considered at high risk for heart disease due to factors such as age, existing health conditions, or a history of heart-related problems.
The goal was to see whether aiming for a systolic blood pressure below 120 mm Hg would lead to better health outcomes than the standard approach of keeping it below 140 mm Hg.
Participants in the study were divided into two groups. One group received standard blood pressure treatment, while the other received more intensive treatment designed to lower their systolic blood pressure to under 120 mm Hg. Both groups were carefully monitored over time so researchers could track heart attacks, strokes, hospitalizations, and deaths.
The results were striking. People in the intensive treatment group experienced a 12 percent reduction in major heart-related events compared to those receiving standard treatment. These events included heart attacks, strokes, deaths caused by heart disease, hospital stays for heart failure, and procedures needed to restore blood flow to the heart.
Even more impressive was the impact on deaths related specifically to heart and blood vessel disease. The study found that intensive blood pressure control reduced cardiovascular deaths by 39 percent.
This means that nearly four out of ten heart-related deaths could potentially be prevented through stricter blood pressure management in high-risk individuals.
The benefits did not stop there. Researchers also looked at deaths from all causes, not just heart disease. They found that people in the intensive treatment group were 21 percent less likely to die from any cause during the study period. This suggests that better blood pressure control can improve overall health and survival, not just heart-related outcomes.
One concern with lowering blood pressure too much is safety. Doctors worry that very low blood pressure could lead to dizziness, fainting, falls, kidney problems, or dangerous changes in body salts. To address this, the researchers closely tracked side effects and complications.
The study found that intensive blood pressure control did not significantly increase the risk of serious problems such as severe low blood pressure, kidney damage, dangerous electrolyte imbalances, or injuries from falls. There was a small increase in fainting episodes, known as syncope, but these events were rare and generally not severe.
These findings are important because they challenge long-standing ideas about how low blood pressure should go. High blood pressure affects hundreds of millions of people worldwide and is one of the strongest risk factors for heart disease and stroke. Even small improvements in how it is managed could have a major impact on public health.
For people at high risk of heart disease, this study suggests that aiming for a systolic blood pressure closer to 120 mm Hg may offer much stronger protection than the traditional target of 140 mm Hg. This could help prevent heart attacks, reduce hospital visits, and save lives.
However, blood pressure treatment is not the same for everyone. Age, other medical conditions, medications, and overall health all play a role in determining what blood pressure target is safest and most effective. Patients should not change their treatment on their own but should talk with their healthcare providers about what approach is best for them.
Overall, this research highlights the power of prevention. By managing blood pressure more carefully and aiming for lower targets when appropriate, doctors may be able to significantly reduce the burden of heart disease. For those at high risk, intensive blood pressure control could be a key step toward a longer, healthier life.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and coconut sugar could help reduce blood pressure and artery stiffness.
For more information about blood pressure, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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