Monday, September 14, 2015

HEALTH - Blood Pressure Targets

What?!  I've had high blood pressure for decades and my doctor set my target as less than 120/80.  So this is 'new?'

"Study:  Lower targets for blood pressure can prevent heart attacks and strokes" PBS NewsHour 9/11/2015


SUMMARY:  For patients over 50, having blood pressure below the commonly recommended targets can drastically reduce the risk of heart disease and strokes.  That’s according to a major blood pressure study from the National Institutes of Health, which called the information "potentially lifesaving."  Hari Sreenivasan speaks to Dr. Gary Gibbons of the National Heart, Lung and Blood Institute.

HARI SREENIVASAN (NewsHour):  There’s news out from the National Institutes of Health today that could change the way we deal with blood pressure.  Researchers found that, for many patients over 50, blood pressure far below the commonly recommended targets can drastically reduce the risk of heart attacks, strokes and deaths.

Doctors said the top line of a blood pressure reading should be below 120 for many.  Prior recommendations put the number at 140.  In fact, the NIH announced the end of a major blood pressure study a year early, saying it was potentially lifesaving information.

Dr. Gary Gibbons is director of the National Heart, Lung and Blood Institute at NIH, which sponsored the trial. He joins us now.

Dr. Gibbons, first of all, break this down for us.  Why is this significant?

DR. GARY GIBBONS, National Heart, Lung and Blood Institute:  Well, as you know, Hari, 70 million Americans have high blood pressure.

It predisposes to the leading causes of death, such as heart disease and stroke.  And we knew for a long time that treating high blood pressure was important to prevent these complications.  But there was a lot of uncertainty as to how low doctors should go and bringing that pressure down.

The SPRINT study, Systolic Blood Pressure Intervention Trial, was designed to ask and answer that question.  And now we have those interim results that make it very clear that being aggressive and intensive treatment regimen that goes to that lower target below 120 millimeters of mercury shows great benefit in reducing the complications such as heart attacks, heart failure and stroke and saves lives.

HARI SREENIVASAN:  When you start to say low blood pressure, people are going to start becoming concerned about the elderly, for whom low blood pressure can lead to dizziness or fainting.  How do you figure out if 120 is right for you?

DR. GARY GIBBONS:  Well, as in all things, that we must balance the benefits against potential harms.  And that’s why it’s important for each patient to consult their care provider to see what’s the right target for them.

But it’s important to note that this study included individuals 50 and over, and indeed included — one-fourth of the study sample with age 75 or older.  So it was inclusive of the elderly.  Indeed, our preliminary analysis suggest that the benefit, we’re seeing across the diverse group of people in the study sample, including those over 75.

So, we think that this may be broadly applicable to those 50 and older who are at increased risk of cardiovascular disease.

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