Lowering Systolic Blood Pressure Can Save More than 100,000 Lives Annually

Intensive treatment may reduce hypertension.

Although current guidelines recommend keeping systolic blood pressure below 140 mm Hg, new findings revealed that lowering it to below 120 mm Hg will save more than 100,000 lives a year in the United States.

Hypertension is the leading risk factor for heart disease, kidney failure, stroke, and other health issues. In the United States, it’s estimated that 1 in 3 people have high blood pressure.

In the new study, researchers wanted to determine whether or not intensive treatment to lower systolic blood pressure could alter mortality. Researchers applied findings from a multicenter study called Systolic Blood Pressure Intervention Trial (SPRINT) to the US adult population.

The SPRINT trial included more than 9350 adults ages 50 and older, who had high blood pressure, and were at a high risk for developing cardiovascular disease. The results of the trial showed that, compared with the standard systolic blood pressure of below 140 mm Hg, there was a 27% reduction in mortality from all causes when systolic blood pressure was lowered to below 120 mm Hg.

Of the 100,000 lives saved per year, two-thirds would be men, and two-thirds would be age 75 and older.

“When the treatment goal was lowered to a maximum of 120 mm HG, there was a huge reduction in mortality,” said first study author Holly Kramer, MD, MPH. “Few other medical interventions have such a large effect.”

Although an intensive blood pressure regimen could save lives, it would also cause some serious side effects. According to the study, if intensive systolic blood pressure lowering in US adults who meet SPRINT criteria was implemented, there would be approximately 55,500 more episodes of low blood pressure, 33,000 more episodes of fainting, and 44,400 additional electrolyte disorders annually.

Authors noted, however, that most of these effects would not be expected to have lasting consequences, and would be reversible by lowering blood pressure medications.

Participants in the SPRINT study treated to achieve a standard target of less than 140 mm Hg received an average of 2 different blood pressure medications. Those who were treated to achieve a target of less than 120 mm Hg, received an average of 3 medications. Certain patients, such as those who smoked or had diabetes, were excluded from the study.

Researchers used data from the National Health & Nutrition Examination Survey to determine that more than 18.1 million American adults met the criteria of patients enrolled in the SPRINT trial. They estimated that among the 18.1 million adults, implementing an intensive regimen to lower systolic blood pressure to below 120 mm Hg would prevent about 107,500 deaths annually.

The findings were presented at the American Heart Association’s Council on Hypertension 2016 Scientific Sessions.