Harvard Health Letter

Should you rethink high blood pressure treatment?


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Initial results of a large national clinical trial suggest that being more aggressive in treating high blood pressure may save lives. Results of the Systolic Blood Pressure Intervention Trial (SPRINT) aren't yet published, so we don't know all of the details. But from information released by the National Institutes of Health (NIH) in September, it appears that aiming for a systolic (top) blood pressure reading of less than 120 mm Hg may reduce the risk of heart attacks, strokes, and heart failure by almost a third, and reduce the overall death rate by 25%. Researchers came to this conclusion after following more than 9,000 middle-aged and older adults with high blood pressure for several years. Half of the participants took an average of two medications and set a target systolic blood pressure of less than 140 mm Hg, the current recommended number. The other half took an average of three medications and aimed for a systolic blood pressure of less than 120 mm Hg. The results in the lower-target group were so impressive that NIH stopped the study early to share the news. Does this mean you should add more pills to your blood pressure treatment? "Not necessarily, because there may be more drug side effects. But if you're aiming for a lower number, I think it will be critical to rely on lifestyle modification, such as stress reduction, diet, salt restriction, and exercise, in addition to medication to lower blood pressure," says Dr. Randall Zusman, a cardiologist and Harvard Medical School associate professor.