Researchers from Mass General Brigham analysed large health databases and previous clinical trials to compare how different blood pressure goals impact long-term health outcomes. Using data from sources such as the Systolic Blood Pressure Intervention Trial (SPRINT) and the National Health and Nutrition Examination Survey (NHANES), they created models that simulated how many heart attacks, strokes, and cases of heart failure might be prevented by treating people more intensively.
The study found that targeting blood pressure below 120 mm Hg prevented more cardiovascular events than higher goals like 130 mm Hg, even after considering common measurement inaccuracies that occur in everyday clinical settings. This suggests that pursuing a stricter treatment target could lead to fewer serious heart-related illnesses over time.
However, lowering blood pressure more intensively isn’t without drawbacks. Patients treated to reach the stricter goal had a greater chance of experiencing side effects related to medications, including falls, kidney injury, very low blood pressure (hypotension), and slow heart rate (bradycardia). Additionally, stronger treatment required more doctor visits and medications, which increased overall healthcare costs.
Despite these challenges, the researchers concluded that the lower blood pressure target remained cost-effective when compared with higher targets. They estimated the cost to be about $42,000 per quality-adjusted life-year gained, a standard measurement used in healthcare to evaluate the value of medical interventions.
Lead author Dr. Karen Smith said the findings should give patients at high cardiovascular risk and their doctors more confidence in pursuing intensive blood pressure control.
“Our findings suggest the intensive less than 120 mm/Hg target prevents more cardiovascular events and provides good value, and this holds true even when measurements aren’t perfect,” said Dr. Smith.
She emphasised, however, that treatment decisions should be personalised, as not all individuals will benefit equally from very aggressive blood pressure lowering.
While there is some risk associated with lowering blood pressure more aggressively, this strategy may prevent more heart attacks, strokes, and heart failures and still be worth the investment for many patients, especially those at higher risk for cardiovascular disease.
Leave a Reply