A new study led by researchers from Mass General Brigham suggests that aiming for lower blood pressure may help prevent more heart-related health problems, even if the measurements are not always perfect.
The findings were published in the Annals of Internal Medicine and provide evidence that stricter blood pressure control could benefit many people with high blood pressure.
Doctors usually set goals for how low a patient’s systolic blood pressure should be. Systolic pressure is the top number in a blood pressure reading and shows how much pressure the blood is exerting on artery walls when the heart beats.
This study looked at three common target levels: below 120 mm Hg, below 130 mm Hg, and below 140 mm Hg. Researchers used a computer simulation to see what would happen to people’s health over their lifetimes at each of these targets.
The simulation used data from major sources including the SPRINT clinical trial and the National Health and Nutrition Examination Survey (NHANES).
It tracked health outcomes like heart attacks, strokes, heart failure, and possible side effects of blood pressure medications. Importantly, the model also included common errors that happen during blood pressure checks in everyday clinical practice.
The results showed that the <120 mm Hg target was the most effective at preventing serious heart problems, even when some measurement errors were included.
However, it also came with a slightly higher risk of side effects from medications, including dizziness, falls, kidney issues, very low blood pressure, and slow heart rate. Also, reaching this stricter target required more medications and doctor visits, increasing overall healthcare costs.
To understand whether this stricter treatment is worth the extra cost and risk, researchers calculated the cost-effectiveness. They found that the <120 mm Hg target had a cost of $42,000 for every quality-adjusted life-year gained. In the world of health economics, this is considered a good value.
Dr. Karen Smith, the lead author and a researcher at Brigham and Women’s Hospital, said the results should give patients and doctors more confidence in choosing a more aggressive blood pressure goal. She noted that this lower target helped prevent more heart problems and provided good value, even when blood pressure readings weren’t always accurate.
However, she also advised caution. Although the results support the benefits of stricter blood pressure control at a population level, it may not be the best choice for every individual.
Because of the increased risk of side effects, she emphasized that patients and their doctors should work together to decide on the best blood pressure target. The decision should be based on each patient’s health needs, preferences, and risk of side effects.
This study helps clarify the ongoing debate about how low blood pressure should go. It suggests that more intensive treatment can help many people live longer and healthier lives, but personal care plans are still essential.
If you care about blood pressure, please read studies that widely used blood pressure drug may increase eye disease risk and common blood pressure drugs linked to cognitive decline.
For more about blood pressure, please read studies about why checking blood pressure while lying down is very important and lowering top blood pressure number to less than 120 mm Hg effectively prevents heart disease.
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