Study: More blood pressure medicine can cut heart, stroke risk

According to a new study published in the New England Journal of Medicine, cardiac disease and deaths related to stroke are greatly reduced in individuals who maintain a blood pressure of 120, lower than the commonly recommended target. The results of the study indicated an enormous difference in the health of patients who targeted below 120, rather than the widely recommended blood pressure of 140.

For the study, more than 9,000 people (aged 50 or older) were tracked for one year, and fewer heart attacks and deaths were observed and studied amongst those patients whose doctor aimed to reach a blood pressure reading of 120mm. Precisely, risk of heart attack minimized to about a third, and deaths went down by a quarter in patients with lower blood pressure.

The advantages of aggressive blood pressure treatment were phenomenal despite the fact that they came at the cost of some health issues. An increased risk of fainting, too low blood pressure, and acute kidney injury/kidney failure was also observed in patients who underwent intensive blood pressure treatment.

“It’s a great study that provides evidence that some people should consider a lower target blood pressure than has been previously recommended. But there are lots of caveats and people should not panic if there blood pressure is above 120,” Yale cardiologist Harlan Krumholz, who was not involved in the study, said.

More than 9,300 people older than 50 volunteered in the study with systolic pressure of 130 or higher. Half received two drugs or more, on average, to reduce their blood pressure to less than 140, and half received three drugs with a target goal of 120.

The results were comprised of people older than 50 who had blood-pressure readings of 130 or higher. People at a greater risk, including those with diabetes, were not included. It isn’t a blanket call to cut blood-pressure goals, Yang said.

“It doesn’t mean that everybody over 50 who met the inclusion criteria should be targeted to a blood pressure of lower than 120,” Yang said. People concerned about their own blood-pressure levels should talk to their healthcare providers about whether it would be helpful to try to achieve lower readings, he added.

The results will certainly embark a dynamic debate over whether guidelines for treating hypertension should be changed to the lower target. “The magnitude of benefit has been so clearly demonstrated that we do believe the evidence from the Sprint trial should be considered when providers and the guidelines committees decide what should be the optimal blood pressure target,” said Dr. Jackson Wright, lead author of a New England Journal of Medicine article on the study.

Researchers are still evaluating and studying the data to see if more intensive blood pressure lowering affects cognitive decline in any way, or has an impact on long-term kidney disease. Prof. Perkovic has written an editorial on the research, published in the New England Journal of Medicine. “There are very few treatments proven to reduce the risk of death among mostly healthy people, but lowering blood pressure to low target levels is now one of them,” he told AAP.