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Q&A: ‘Landmark’ study supports new, more aggressive blood pressure targets below 120/90

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Researchers from the National Institutes of Health reported Friday that the results of a clinical trial into optimal blood pressure targets were so revealing that they were ending the study a year early to be able to communicate the results to the public.

Gary Gibbons, director of the National Heart, Lung, and Blood Institute, said that the study showed that lowering systolic pressure to 120 millimeters of mercury (mm Hg) in people 50 and older -- as opposed to 140 as is currently recommended -- resulted in reduced rates of heart attacks, stroke and death.

"This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options," he said.

If you're on blood pressure medication or are thinking about it, here's what you should know about the announcement:

[Blood pressure study provides potential ‘lifesaving’ guidelines]

What do the current clinical guidelines say about blood pressure targets?

They recommend a systolic blood pressure of less than 140 mm Hg for healthy adults. It's 130 mm Hg for adults with kidney disease or diabetes. Systolic blood pressure is the top number in blood pressure readings and is a measure of the pressure when the heart muscle contracts.

The bottom number is known as diastolic pressure and is recommended to be below 90 mm Hg.

The 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults, published in the Journal of the American Medical Association can be found here.

Tell me about the design and findings of the new study.

Called SPRINT, or the Systolic Blood Pressure Intervention Trial, the study began in the fall of 2009 and enrolled more than 9,300 patients 50 years and older for increased risk of heart disease or who have kidney disease.

The study participants were randomly divided  into two groups that had different targets for blood pressure control. One group received blood pressure medications to bring their blood pressure to less than 140 mm Hg. The other aimed for less than 120 mm Hg. The first group received an average of two medications and the second three medications.

The researchers tracked the two groups over time and found that the group that had a target of 120 mm Hg experienced reduced rates of cardiovascular events, such as heart attacks, heart failure and stroke. Their risk of death was reduced by almost a quarter  compared with the group with a 140 mm Hg target.

The study did not address diastolic blood pressure.

I have high blood pressure. Does this mean I should start taking more medicine in order get my systolic blood pressure to 120 mm Hg or below?

That's something to discuss with your health care provider. In some people, especially those over age 75, taking more medicine may be risky, and the possible side effects, interactions or impact on other organs should be weighed against the potential benefits of the reduction in risk of heart events. Keep in mind that there are ways to lower blood pressure other than medicine, including exercising regularly and eating healthy foods low in salt.

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