Lowering systolic blood pressure could save lives

When it comes to blood pressure, having a lower systolic number than the current guidelines could save lives, according to results from the clinical trial sponsored by the National Institutes of Health.

Researchers found that when systolic blood pressure, which is the top number in a blood pressure reading, is less than 120, there is a significantly lower rate of cardiovascular disease and a lower risk of death compared to individuals with a blood pressure reading lower than 140.

“Managing blood pressure is important because high blood pressure is a leading risk factor for heart disease, stroke, kidney failure and other health problems,” says Dr. Jane Luecking, an Advocate Medical Group family medicine physician at Advocate Condell Medical Center in Libertyville, Ill.

The study included more than 9,300 participants 50 years old and older at increased risk for heart disease or with kidney disease. Participants were divided into two groups based on the health conditions.

One group received two types of blood pressure medications with a goal of maintaining the systolic number below 140. The second group received more intensive treatment with a goal of maintaining their systolic reading below 120. This group also received medication, but were given an average of three different types.

When comparing the groups, researchers found those aiming for a blood pressure reading of 120 or less reduced their risk of heart attack, heart failure and stroke by about 33 percent, and reduced their risk of death by almost 25 percent compared to those who were aiming for a reading of 140 or less.

The NIH stopped the study more than a year earlier than originally planned because researchers wanted to get the word out quickly. Blood pressure guidelines could be changed because of the findings.

Currently, people who have a systolic reading at 140 or above are said to have high blood pressure and their diastolic reading is at or above 90, according to the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. An estimated one in three people in the U.S. has high blood pressure.

It is becoming more common for health care experts to recommend regular blood pressure monitoring at home for people with hypertension or pre-hypertension because keeping track of blood pressure readings over time offers a more accurate picture than a single reading taken during an appointment.

“I always think more data is better,” Dr. Luecking says. “It’s better to make a decision based on 10 readings rather than one.”

If patients choose to monitor blood pressure at home, Dr. Luecking suggests they use a device with an arm cuff and to bring their device to the office so it can be measured for accuracy.

Lowering blood pressure or managing it at a healthy level often requires lifestyle modifications, Dr. Luecking adds.

“Watching what you eat is important,” she says, noting that dietary changes could include eating fewer processed foods and more fruits and vegetables.

In addition to a healthy eating plan, Dr. Luecking suggests following these NIH guidelines :

• Maintain a healthy weight
• Be physically active
• Reduce sodium in your diet
• Drink alcohol only in moderation
• Take prescribed drugs as directed

Do you know your risk for heart disease? Take Advocate Heart Institute’s heart risk assessment here. If you are at high risk, see an Advocate cardiologist within 24 hours.