Aggressive Blood Pressure Treatment Cuts Death: Study
In the study of more than 9,300 patients with hypertension, lowering blood pressure below a commonly used target significantly reduced serious heart problems and cut the risk of death in adults aged 50 and older.
The preliminary results of a large U.S. government-sponsored study released on Friday, September 11, 2015, reported that using a combination of medicines to reduce systolic pressure to a target of 120 versus 140 cut the rate of heart attacks, strokes and heart failure by almost a third and the risk of death by nearly a quarter.
"This study provides potentially life-saving 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," Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute (NHLBI), which sponsored the study, said in a statement.
Systolic blood pressure, the arterial pressure when the heart contracts, is the top number in a blood pressure reading. High blood pressure is widely considered a leading risk factor for heart disease, kidney failure and other health problems. Many of these health issues can cause death or increase the risk of the need of Long Term Health Care.
The vast majority of blood pressure medicines from a variety of classes are available as inexpensive generics. The classes include angiotensin receptor blockers, or ARBs, such as Novartis' Diovan, calcium channel blockers, like Pfizer's Norvasc, ACE inhibitors, including Pfizer's Altace, and diuretics, such as Merck's Hyzaar.
Doctors on a conference call to discuss the study said blood pressure of 120 over 80 was seen as desirable, but that 140/90 was a commonly used target. They also noted that there is no real consensus, which was a reason for conducting the trial.
"Patients should talk to their doctor to determine whether this lower goal is best for their individual care," said Dr. Lawrence Fine, chief of Clinical Applications and Prevention at the NHLBI.
One in three Americans over the age of 18 years suffers from hypertension according to the Cleveland Clinic . They indicate the prevalence is higher among older individuals, women and non-Hispanic blacks. Despite the increase in prevalence, recent data from the National Health and Nutrition Examination Survey (NHANES) demonstrate an improvement in blood pressure control (50%) among Americans with hypertension. However, the blood pressure control rate remains suboptimal in people who have serious comorbid conditions such as chronic kidney disease.
Control of blood pressure has many positive impacts on health. The Alzheimer’s Association says several conditions known to increase the risk of cardiovascular disease — such as high blood pressure, diabetes and high cholesterol — also increase the risk of developing Alzheimer's. Some autopsy studies show that as many as 80 percent of individuals with Alzheimer's disease also have cardiovascular disease.
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