Hypertension

11 November 2015

Aggressive blood pressure control could help millions

Healthy lifestyle choices and using blood pressure medication can decrease the risk of stroke and heart attack in people over 50.

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A more aggressive approach to lowering blood pressure could help millions of people over age 50, according to the results of a major US study.

Patients who lowered their systolic number, meaning the higher of the two figures used to express blood pressure to less than 120 mm Hg saw their risk of heart attack, heart failure or stroke drop by 24 percent, and their risk of death plummeted by 27 percent.

Positive results

Current guidelines urge adults to keep their blood pressure below 140 mm Hg.

In September, the National Institutes of Health-sponsored study was stopped a year early due to the positive results.

A detailed report on its findings was published in the New England Journal of Medicine.

Read: New blood pressure guidelines

"The positive results of this trial have taken most investigators by surprise, and the strong benefits of treatment seem to outweigh the risks," said co-author Alfred Cheung, chief of nephrology and hypertension at University of Utah Health Care.

However, more research is needed before health authorities can recommend a change to current guidelines.

"Before deciding to treat blood pressure aggressively, it may be prudent to wait until additional questions are answered," Cheung added.

The treatment, which involves using medications to lower blood pressure along with healthy lifestyle choices, also came with an increased risk for some serious side effects, including blood pressure that fell too low, fainting, and kidney problems.

Read: Meditation controls blood pressure

Researchers are also still investigating how the treatment might affect cognition, dementia and kidney disease.

History of diabetes or stroke

The study involved more than 9,300 people who were randomly assigned to a blood pressure target of either 120 mm Hg or 140 mm Hg.

All the study participants were aged 50 or older and had faced an increased risk of cardiovascular disease, having a systolic blood pressure of at least 130 mmHg.

They also had no history of diabetes or stroke, a requirement which made the study population majority white, and tended to exclude many African Americans and Hispanics.

About 16.8 million people in the United States would fit the study and criteria and therefore might benefit from the approach, researchers said.

Read: Blueberries may help to control blood pressure

"Given that millions of US adults meet SPRINT eligibility criteria, the implementation of SPRINT recommendations could have a profound impact on how blood pressure is treated in this country," said senior author Paul Muntner, a professor of epidemiology at the University of Alabama.

"Even more important, is its potential for greatly reducing the incidence of cardiovascular disease." More than one billion people worldwide have hypertension, which is defined as a systolic blood pressure of 140 or more, over a diastolic blood pressure of 90 or higher.

Read more: 

treating hypertension 

Blood pressure linked to dementia  

Severe sleep apnoea aggravates blood pressure risk 

 

Ask the Expert

Hypertension expert

Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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