More Aggressive Treatment of High Blood Pressure Saves Lives in Study

The AHA guidelines currently recommend a systolic pressure of less than 140 millimeters of mercury for most adults with high blood pressure. But doctors say new findings presented at the American Heart Association Scientific Sessions 2015 support a steeper goal of 120 — a reduction that could translate into doctors putting millions more Americans with high blood pressure on additional medication.

The study found that hitting the lower 120 target reduced the risk of dying from cardiovascular causes by 43 percent.

The Systolic Blood Pressure Intervention Trial, or SPRINT, included more than 9,300 people with high blood pressure who were age 50 and older and had at least one other risk factor for heart disease and stroke. The patients were followed for a median of more than three years, much shorter than expected because investigators stopped the trial early after seeing the striking results.

Using medications to lower systolic blood pressure to around 120 reduced the risk of having or dying from a heart attack, stroke or heart failure by a quarter, compared with lowering it to the previously recommended target of less than 140. During the study, 243 patients in the intensive treatment group had a so-called event versus 319 patients in the standard treatment group.

When investigators looked only at deaths caused by heart disease and stroke, the nation’s No. 1 and No. 5 killers, the risk of dying fell by 43 percent in the more aggressively treated group, with 37 deaths in the intensive therapy group and 65 deaths in the standard therapy group.

Blood pressure medications are relatively affordable — nearly all are available as low-cost generics — meaning that more doses won’t burden patients with higher bills. Nor did researchers find that giving patients more drugs increases the risk of most serious side effects.

“This is likely the most important blood pressure study in the past 40 years,” said Daniel Jones, M.D., interim chairman of the department of medicine at the University of Mississippi Medical Center, who was not involved in the study. “It’s one that should and will change the practice of treating high blood pressure around the world.”

High blood pressure contributed to more than 405,000 U.S. deaths in 2013. Globally, the World Health Organization estimates it causes 7.5 million deaths.

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