High blood pressure, also called hypertension, affects hundreds of millions of people around the world.
It often has no warning signs, but over time it can damage blood vessels and greatly increase the risk of heart attacks, strokes, heart failure, kidney disease, and early death.
Because of these dangers, controlling blood pressure is one of the most important ways to protect long-term health.
Doctors have long agreed that lowering high blood pressure is beneficial, but they have debated how low it should go. Some experts believe aiming for a lower blood pressure target offers the best protection against heart disease.
Others worry that lowering blood pressure too much could increase the risk of side effects, especially in older adults or people with several medical conditions.
A new study from researchers at Mass General Brigham provides fresh evidence in this debate. The team found that aiming for a lower blood pressure target may offer greater health benefits than higher targets for many people who have a high risk of heart disease. Their findings were published in the Annals of Internal Medicine.
Instead of following patients for decades, the researchers used a detailed computer model to estimate what would happen over a person’s lifetime.
They combined information from several large studies, including the well-known SPRINT trial, national health surveys, and previous scientific research. This approach allowed them to compare the long-term effects of different blood pressure goals.
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 beats. They compared three treatment targets: below 140, below 130, and below 120 millimeters of mercury.
The computer model estimated the number of heart attacks, strokes, cases of heart failure, and deaths that might occur under each treatment strategy. It also considered the possible harms of more intensive treatment, including dizziness, falls, kidney injury, slow heart rate, and very low blood pressure.
The researchers even included the small measurement errors that commonly happen when blood pressure is checked in everyday medical practice.
The results showed that people whose blood pressure was lowered to below 120 had fewer serious cardiovascular events than those treated to higher targets. Although more intensive treatment increased the chance of medication-related side effects, the overall health benefits remained greater than the risks for many high-risk patients.
The researchers also examined healthcare costs. Even though stricter treatment required more medicines, monitoring, and medical visits, it was still considered cost-effective according to widely accepted healthcare standards. Preventing expensive illnesses such as heart attacks and strokes helped balance the extra treatment costs.
The team emphasized that these findings do not mean everyone should aim for the same blood pressure target. Some people may be more likely to develop side effects or have medical conditions that make intensive treatment less suitable. Decisions about treatment should always consider a person’s age, overall health, medical history, and personal preferences.
The study was led by researchers at Mass General Brigham and published in the Annals of Internal Medicine. Overall, the findings strengthen the evidence that carefully lowering blood pressure to below 120 can prevent more heart attacks, strokes, and heart failure in many people at high cardiovascular risk.
At the same time, the research highlights the importance of personalized care, where doctors and patients work together to balance the benefits and possible risks. As more evidence becomes available, treatment plans can continue to become safer, more effective, and better suited to each individual.
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.
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