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How Low Should Your Blood Pressure Be?

New study shows fewer heart attacks and deaths in those with lower BP

Since an estimated one in three people in the United States has high blood pressure, which puts them at risk for heart disease and stroke, kidney failure and other health problems, determining an ideal blood pressure is vital.

According to a new study, which was ended more than a year early because of “potentially lifesaving information,” the optimal number may be lower than the current blood pressure guidelines, researchers said Friday.

Currently, a systolic reading of less than 140 mmHg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes is recommended.

(The systolic number is the higher of the two numbers; the number represents the pressure on blood vessels when the heart beats and the muscle contracts.)

This landmark clinical trial, called SPRINT (Systolic Blood Pressure Intervention Trial), the largest of its kind, was designed with this question in mind: Would lowering that number to less than 120 benefit the health of hypertensive adults age 50 years and older?

‘Very Significant’ Results

To investigate the answer, more than 9,300 men and women at high risk for heart disease or with kidney disease were randomly divided into two groups. One group’s target systolic rate was less than 120; they were treated with an average of three medications to regulate blood pressure. The other group had a target rate of less than 140; they received an average of two medications.

Results suggest that this study might pave the way for new and lower guidelines for blood pressure management. That’s because those patients who achieved a systolic reading below 120 showed significant and compelling outcomes. Their risk of heart attacks, heart failure and strokes were reduced by a third and their risk of death reduced by nearly a quarter.

Calling the study “very significant,” Dr. Elliott Antman, professor of medicine and dean for clinical/translational research at Harvard Medical School, says that so far the information seems to indicate that a target blood pressure of 120 mm Hg or less is preferable to one of 140 mm Hg or less.

Results suggest that this study might pave the way for new and lower guidelines for blood pressure management.

Antman, who is also the past president of the American Heart Association and was not involved with the study, adds “since this was a large, rigorously performed randomized trial, it is the kind of evidence that typically has an impact on guidelines.”

Gary H. Gibbons, M.D., who is the director of the National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of the study, said in a statement, “This study provides potentially lifesaving information that will be useful to healthcare providers as they consider the best treatment options for some of their patients, particularly those over the age of 50.”

7 Ways to Lower Blood Pressure

Check out these tips from the Mayo Clinic:

  1. Lose extra pounds. Losing just 10 pounds can help; so can whittling your waist. Women whose waist measures greater than 35 inches and men with a number greater than 40 inches are at greater risk of high blood pressure.
  2. Aim for regular physical activity – at least 30 minutes most days of the week. Best types include walking, jogging, cycling, swimming or dancing. Strength training helps, too.
  3. Eat healthy. Include whole grains, fruits, vegetables and low-fat dairy. Watch your saturated fat and cholesterol. The DASH diet (Dietary Approaches to Stop Hypertension) is designed to lower blood pressure.
  4. Watch your salt. In general, have no more than 1,500 milligrams a day. That’s equivalent to just ¾ of a teaspoon.
  5. Limit your alcohol. Although it can potentially help lower blood pressure (in small amounts), drinking too much can actually raise it, and may also reduce effectiveness of any blood pressure medications. What’s too much? Generally, it’s more than one drink a day for women, and men older than 65, or more than two a day for men 65 and younger.
  6. Quit smoking.
  7. Reduce stress.

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