Aggressive high blood pressure treatment may save lives

Lowering blood pressure below a commonly recommended target may significantly reduce the risk of heart disease and deaths, particularly for patients aged 50 years and older, U.S. government researchers announced Friday.

The findings came in what the U.S. National Institutes of Health (NIH) called "a landmark clinical trial," the Systolic Blood Pressure Intervention Trial (SPRINT). The NIH said in a statement that the study, which began in the fall of 2009, was halted earlier than planned "in order to quickly disseminate the significant preliminary results."

"This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50," said Gary Gibbons, director of the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH and the primary sponsor of SPRINT.

High blood pressure, or hypertension, is a leading risk factor for heart disease, stroke, kidney failure, and other health problems. Currently, the well-established clinical guidelines recommended a systolic blood pressure of less than 140 millimeters of mercury (mm Hg) for healthy adults and 130 mm Hg for adults with kidney disease or diabetes.

The SPRINT study, which recruited more than 9,300 people aged 50 and older from the United States and Puerto Rico, aimed to examine how maintaining a systolic pressure of 120 mm HG will impact cardiovascular and kidney diseases.

Between 2010 and 2013, the SPRINT investigators randomly divided the study participants into two groups. The standard group received an average of two different blood pressure medications to achieve a target of less than 140 mm Hg. The other group received an average of three medications with the goal of getting below 120 mm Hg.

The study population was diverse, but did not include patients with diabetes, prior stroke, or polycystic kidney disease, the NIH said.

It showed that the intervention for a target of 120 mm Hg reduced rates of cardiovascular events, such as heart attack and heart failure as well as stroke, by almost a third and the risk of death by almost a quarter, as compared to the target of 140 mm Hg.

"Our results provide important evidence that treating blood pressure to a lower goal in older or high-risk patients can be beneficial and yield better health results overall," said Lawrence Fine, head of the NHLBI's clinical applications and prevention branch. "But patients should talk to their doctor to determine whether this lower goal is best for their individual care."