Lower isn't necessarily better for people with high blood pressure

June 16, 2014

For decades, common medical wisdom has been "the lower the better" in treating the approximately one in three people in this country who have high blood pressure. But does that approach result in reduced risk for dangerous heart events?

In a study published in the June 16 online edition of JAMA Internal Medicine, researchers at Wake Forest Baptist Medical Center found that lowering systolic blood pressure below 120 does not appear to provide additional benefit for patients. Systolic pressure is the top number in a standard blood pressure reading (e.g., 120/80).

"Frequently we treat patients' blood pressure to the lowest it will go, thinking that is what's best," said Carlos J. Rodriguez, M.D., associate professor of public health sciences at Wake Forest Baptist and lead author of the study.

"Our observational study found that treating to low pressures doesn't provide any benefit to patients with regard to reducing risk of dangerous heart events like heart attack, and stroke. This calls into question the notion that lower is better."

Previous studies had documented a progressive increase in as (SBP) rose above 115, but it was not known whether SBP lower than 120 in patients with hypertension (HTN) lowered the risk of heart failure, stroke and heart attack.

In this study, a total of 4,480 participants from the Atherosclerosis Risk in Communities Study were followed for 21 years for development of a . Measurements of SBP were taken at baseline and at three-year intervals. SBP was categorized as elevated (140 or greater), standard (120 -139) or low (less than 120). The study findings were independent of baseline age, gender, diabetes status, body mass index, cholesterol level, smoking status and alcohol intake. A cardiovascular event was defined as heart failure, ischemic stroke, heart attack or death related to coronary heart disease.

The researchers found that among people with , once SBP is below 140, lowering it below 120 did not further reduce the risk of cardiovascular events.

"Our study found that the optimal range for people with hypertension is120-139, which significantly reduces the risk of stroke, or heart failure," Rodriguez said. "These findings suggest that you don't need to go lower than that to have the benefits."

Rodriguez said that his study was not a clinical trial and its results need to be confirmed; noting that a large clinical trial under way called SPRINT should either confirm or refute the findings.

Explore further: Study evaluates 'normal range' systolic bp levels after ischemic stroke and risk of recurrent stroke

Related Stories

Study evaluates 'normal range' systolic bp levels after ischemic stroke and risk of recurrent stroke

November 15, 2011
Among patients who experienced an ischemic stroke, systolic blood pressure levels of less than 120 mm Hg, or higher than 140 mm Hg, were associated with an increased risk of subsequent stroke, according to a study appearing ...

New study presents evidence that blood pressure should be measured in both arms

February 25, 2014
As heart disease continues to be one of the leading causes of death in the United States, practitioners and patients alike are looking for ways to cut risk factors and identify new clues to assist with early detection. New ...

Systolic and diastolic blood pressures predict risk of different cardiovascular diseases

May 29, 2014
Raised systolic and diastolic blood pressures may have different effects on different types of cardiovascular diseases and at different ages, according to new research involving 1.25 million patients from primary care practices ...

Consistent blood pressure control may cut rate of second stroke in half

March 27, 2014
Stroke survivors who consistently control their blood pressure may reduce the likelihood of a second stroke by more than half, according to new research in the American Heart Association journal Stroke.

For people with diabetes, aggressive blood pressure goals may not help

November 13, 2013
Many people with diabetes also have high blood pressure. Clinical guidelines have suggested blood pressure levels in people with diabetes should be kept lower than the standard for people without diabetes. However, a new ...

CPAP superior to supplemental oxygen for BP reduction in obstructive sleep apnea

June 11, 2014
Continuous positive airway pressure (CPAP), the most widely prescribed therapy for treatment of obstructive sleep apnea, resulted in significantly lower blood pressure compared to either nocturnal supplemental oxygen or an ...

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.