Will the new blood pressure guidelines impact me?

New research seems to indicate that blood pressure should be lower than previously thought.

The new study, called the Systolic Blood Pressure Intervention Trial, or SPRINT, was funded by the National Institutes of Health in order to answer the following question:

‘Will lower blood pressure reduce the risk of heart and kidney diseases, stroke, or age-related declines in memory and thinking?’

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Jackson T. Wright Jr., a Sprint study investigator and blood pressure expert at Case Western Reserve University and University Hospitals Case Medical Center said that changing blood pressure guidelines to be lower could reduce mortality a great deal.

Will new research lead to new guidelines?

To test this theory, over 9,300 people with elevated blood pressure and a high risk of heart attack were monitored and given medication to reduce their blood pressure. About half of the participants wanted to lower their systolic pressure to 120, and the other half wanted to keep their goal at 140. The current guidelines suggest that a systolic (top number) of 120 millimeters of mercury or less and a diastolic pressure (bottom number) of 80 mmHg or less is optimal. 

But new research discovered that these guidelines (for high-risk individuals, at least) may need to be changed. In fact, the study had such significant findings, it was cut short! 

While the study was active, 65 people monitored with a goal of 140 systolic pressure passed away, while 100 developed heart failure. But of those whose goal was to get down to a systolic 120, 37 died and 62 developed heart failure — a massive decrease in mortality and heart-related health consequences. 

Director of the National Heart, Lung, and Blood Institute, Gary Gibbons, M.D., says the findings will prompt new guidelines for blood pressure and help to save lives. 

However, there significant risks with trying to get your blood pressure down that low.

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The drawbacks of aiming for lower blood pressure

In order to get blood pressure to 120, participants had to take three different blood pressure medicines on average. This then led to serious side effects, including some that resulted in visits to the ER. Some unfortunate side effects included: kidney failure, blood pressure so low it became life-threatening and potassium and sodium imbalances. 

In addition, people often forget to take their medication regularly, and taking more than one medication may increase these challenges, according to Michael Pignone, M.D., chief of internal medicine at the University of North Carolina School of Medicine in Chapel Hill. 

‘Putting somebody on more medications if they’re not consistently taking their current regimen is not a helpful strategy,’ he says.

For those in a high risk category

The Sprint study was focused on a group of high-risk individuals — specifically, the study targeted people over 50 with at least one chronic condition, such as heart disease or kidney disease, and those over 75. But it should be noted that only 1 in 6 people with high blood pressure is in a high-risk category like those studied. 

Harlan Krumholz, M.D., a cardiologist at Yale University recommends talking with your doctor about whether lowering your blood pressure to 120 is worth the risk if you are in a high-risk category.

For everyone else

If you’re not in a high-risk category like the study participants, for people between the ages of 60 and 75 with no other risk factors, medical experts consider 150/90 a reasonable goal. A goal of 140/90 is suggested for people younger than 60, those with diabetes and those younger than 50 with chronic kidney disease. 

But for everyone, low risk or high risk, it is super important to have your blood pressure checked regularly, since uncontrolled blood pressure is the number one cause of heart attacks and stroke.

Best way to measure blood pressure

You might be surprised to learn that the most accurate blood pressure reading won’t come from your doctor’s office. 

Incorrect diagnoses at doctors’ offices average around 30%, usually due to anxiety, but can also be because of sitting position, bladder fullness or incorrect placement of the monitor cuff.

The absolute best way to measure blood pressure is ambulatory monitoring, which records your blood pressure at frequent increments over a 24-hour time span via a small wearable device. But since this device isn’t always widely available or covered by insurance, a good alternative is a home blood pressure monitory. Simply record levels once in the morning and once at night for a week, and the averages should provide you with an accurate blood pressure reading. 

If you find your blood pressure is high, it is recommended to see a doctor, and make lifestyle changes before taking medication. 

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