What are the effects of lowering blood pressure targets?

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In 2017, the American Heart Association (AHA) lowered the threshold for
what constitutes hypertension. However, what is the impact of this, and is implementing these new guidelines cost effective? Two new studies set out to investigate.
Meanwhile, the Centers for Disease Control and Prevention (CDC) estimate that around 1,100Trusted Source people die of a condition related to hypertension each day, including heart disease and stroke. These are some of the leading causes of death in the U.S. The healthcare costs of hypertension are not negligible, either. The CDC suggest that hypertension results in almost $50 billion per year in costs, including the price of medications and missed days of work.
What are some of the measures that people with high blood pressure and healthcare professionals can take to prevent these adverse outcomes and increase lifespan? In 2017, the AHA recommended lowering blood pressure thresholds and treating people at risk more intensively.
Now, two new studies — both of which featured at the AHA’s Scientific Sessions 2019, which takes place in Philadelphia, PA — have investigated the costs and benefits of treating hypertension more intensively, and of tailoring treatment according to degrees of cardiovascular risk.
Dr. Muthiah Vaduganathan, an instructor of medicine at Harvard Medical School and an associate physician at Brigham and Women’s Hospital — both in Boston, MA — is the lead author of the first study. Dr. Vaduganathan and team used data from the well-known Systolic Blood Pressure Intervention Trial (SPRINT).
The SPRINT examined the effects of lowering systolic blood pressure readings to a target of 120 milligrams of mercury (mm Hg) instead of the usual 140 mm Hg.
The trial followed 9,361 participants, all of whom were over the age of 50 and at high cardiovascular risk. The SPRINT followed them for 6 years and concluded that lowering blood pressure targets reduced the risk of cardiovascular problems — such as heart attack, stroke, heart failure, and cardiovascular death — by 25%. The participants were at high risk of heart disease if they had had a cardiovascular disease that was not stroke, scored highly on the 10 year cardiovascular risk score, had chronic kidney disease, or were older than 75. For the new study, the researchers analyzed the data to project the lifespans of the participants who underwent intensive hypertension treatment to lower blood pressure to a target of 120 mm Hg.