Blood Pressure: How Low to Go?

Blood Pressure: How Low to Go?

Sept. 11, 2015 — When it comes to treating high blood pressure, lower is better, a new study shows.

The study, which was stopped early on Friday because the results were so clear and positive for one group of patients, found that getting high blood pressure back down to normal levels — at least 120/80 — dramatically cuts the risk of heart attacks, strokes, and deaths compared to currently recommended BP targets.

“Monday morning, this will be all we talk about,” says Mary Norine Walsh, MD, a cardiologist and vice president of the American College of Cardiology.

“This can have a very large effect on thousands and thousands of people. One in three people in the United States have hypertension, and the majority of those people are over the age of 50,” says Walsh, who was not involved in the research.

The results are contrary to current clinical guidelines. New blood pressure targets released last year advised doctors to loosen treatment targets for patients with high blood pressure. Most patients over age 60, for example, were advised to shoot for a goal of 150/90.

“The trend, I think, in the thinking of the community of physicians who treat high blood pressure has really been more towards higher goals,” says David Reboussin, PhD, professor of public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, N.C. Reboussin was part of a team of doctors who led the study for the National Institutes of Health.

“But most of those opinions were formed really without the benefit of a definitive, large clinical trial to test the hypothesis of whether it is better or not. That’s what we set out to do,” Reboussin says.

The study had enrolled more than 9,000 adults over the age of 50. All of them had high blood pressure. And they all had at least one additional heart risk factor, like a history of heart disease.

Study participants were randomly assigned to two groups. Doctors treated patients in the first group to get their systolic blood pressure to a goal of 140. The goal for the second group was to get their systolic blood pressure back to normal — anything under 120.

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