High blood pressure, also called hypertension, affects millions of people around the world.
It is one of the leading causes of heart attacks, strokes, heart failure, kidney disease, and early death. Because it often causes no symptoms, many people do not realize they have it until serious health problems develop.
For years, doctors have debated how low blood pressure should be reduced with medication. Lowering blood pressure helps protect the heart and blood vessels, but some experts have worried that reducing it too much could increase the risk of falls, kidney problems, dizziness, or other side effects, especially in older adults.
A new study led by researchers at Mass General Brigham suggests that aiming for lower blood pressure targets may provide greater long-term benefits than many people expected. The research was published in the Annals of Internal Medicine.
Instead of following patients for several decades, the scientists built a detailed computer model that combined information from several large, high-quality studies. These included the Systolic Blood Pressure Intervention Trial, known as SPRINT, the National Health and Nutrition Examination Survey, and findings from other published research.
The researchers focused on systolic blood pressure, the top number in a blood pressure reading. This number measures the pressure inside the arteries each time the heart pumps blood. They compared three treatment goals: keeping systolic blood pressure below 140, below 130, or below 120 millimeters of mercury.
The computer model estimated what would happen over a person’s lifetime under each treatment strategy. It calculated the chances of heart attacks, strokes, heart failure, and death while also considering possible side effects from blood pressure medicines.
The researchers included common problems that occur in everyday medical practice, such as blood pressure readings that are slightly too high or too low because of measurement errors. Even after taking these real-world issues into account, the results remained consistent.
People whose systolic blood pressure was lowered to below 120 experienced the fewest serious cardiovascular events. They had lower risks of heart attack, stroke, and heart failure than people whose treatment targets were set higher.
More intensive treatment did increase the likelihood of medication-related side effects, including dizziness, falls, kidney injury, low blood pressure, and a slow heart rate. It also required more medicines, more doctor visits, and higher healthcare costs. Even so, the researchers found that the health benefits outweighed these disadvantages for many people at high cardiovascular risk. The treatment strategy remained cost-effective according to widely accepted healthcare standards.
The researchers stress that one blood pressure target does not fit everyone. Age, other medical conditions, medication tolerance, and personal preferences should all be considered when choosing treatment goals.
Overall, the findings provide strong evidence that carefully supervised intensive blood pressure control can prevent many serious heart problems and save lives while offering good value for healthcare systems.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about How to eat your way to healthy blood pressure and results showing that Modified traditional Chinese cuisine can lower blood pressure.
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