A new study shows that bringing the top number in your blood pressure reading—called systolic pressure—below 120 mm Hg can greatly reduce the risk of heart attacks, strokes, and even death.
This target is stricter than the usual recommendation of keeping systolic pressure below 140 mm Hg.
The research was presented at the American Heart Association’s 2023 Scientific Sessions in Philadelphia and led by Dr. Jing Li from the National Center for Cardiovascular Diseases in Beijing, China. Called the ESPRIT trial, the study followed more than 11,000 adults in China who had high blood pressure and were considered at high risk for heart disease.
Participants were randomly divided into two groups. One group received intensive treatment to lower their systolic blood pressure below 120 mm Hg. The other group received standard treatment, aiming to stay below 140 mm Hg. Both groups used blood pressure medications, but the intensive group took more or higher doses to reach their goal.
After three years, the results were clear. The group with the lower blood pressure had much better outcomes. They were 12% less likely to have major heart problems like heart attacks or strokes, and 39% less likely to die from heart disease. Overall, they were 21% less likely to die from any cause.
This study is especially important for older adults or those who have already had a heart attack or stroke. In this trial, the average age of participants was 64, with 30% having a history of heart disease and 27% having had a stroke before.
Some people worry that lowering blood pressure too much could lead to side effects. In this study, fainting (or syncope) happened slightly more often in the intensive group—about 3 out of every 1,000 patients. But this small risk was far outweighed by the big drop in heart problems and deaths.
Dr. Li and her team believe these findings show that aiming for a lower blood pressure target can help people live longer and avoid serious health issues, especially those at high risk. The results suggest that doctors may want to set lower goals for patients when it’s safe to do so.
Even though the study was done in China, the results match similar studies in other countries. One well-known study, called the SPRINT trial in the United States, also showed that lowering blood pressure below 120 mm Hg helps people with a high risk of heart disease.
More research will follow to learn about the long-term effects of this kind of treatment. But for now, the message is hopeful: keeping your blood pressure lower than 120 could be one of the best ways to protect your heart and live a longer, healthier life.
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