Blood Pressure Study Halted Early for All the Right Reasons

The words “legendary,” “miraculous” and “unique” are so overused in common conversation they’ve almost lost their meaning. Describing a health study as “landmark” falls into the same category.

Except for last week, when the initial results of a clinical trial sponsored by the National Institutes of Health (NIH) proved so impressive about the benefits of managing blood pressure intensively that the study was stopped early.

As reported by NPR, the findings resulted from the largest study ever conducted to examine whether reducing systolic blood pressure (the top number in a blood pressure reading) below the level currently recommended would be beneficial.

Oh yeah. So much so that even the usually staid scientists at the NIH described it as “landmark.”

The trial has shown that achieving a target systolic pressure of 120 millimeters of mercury (mm Hg) reduces rates of heart attack, heart failure and stroke, by almost one-third, and the risk of death by almost one-quarter, compared with former target numbers.

“This is landmark study,” Dr. Gary Gibbons told NPR Friday. He’s director of the National Heart, Lung and Blood Institute (NHLBI), which sponsored the study. In the NIH statement that day, he said, “This study provides potentially lifesaving information that will be useful to health-care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50.”

As originally designed, the study was to continue until 2016. But because the preliminary results were so significant, it was stopped.

About 1 in 3 U.S. adults have high blood pressure. According to the NIH, normal blood pressure for adults is a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg, commonly expressed as 120/80.

Abnormal blood pressure generally is defined as higher than the 120/80 benchmark, but as with most health metrics, individual factors come into play. Blood pressures varies when you’re sleeping, excited, nervous, physically active, etc. That’s why medical caregivers measure it when you’re quiet and calm.

Blood pressure typically rises with age and increasing body weight. People with diabetes or chronic kidney disease are especially vulnerable to the ravages of high blood pressure. When the study was designed, clinical guidelines recommended a systolic blood pressure of less than 140 for healthy adults and 130 for adults with kidney disease or diabetes.

As NPR explained, a robust debate has raged over the wisdom of even lower systolic blood pressure as the preferred measure. That’s what prompted the study, known as SPRINT (Systolic Blood Pressure Intervention Trial), which began in 2009. It included more than 9,300 adults with high blood pressure and at least one other risk factor for heart disease, such as being a smoker or having high cholesterol (but not diabetes, prior stroke or polycystic kidney disease).

Half of that group was supposed to reduce their systolic pressure to 140, and the other to 120. The subjects were diverse in gender, race, ethnicity and age.

“Our results provide important evidence that treating blood pressure to a lower goal in older or high-risk patients can be beneficial and yield better health results overall,” said Dr. Lawrence Fine in the NIH statement. He’s chief of Clinical Applications and Prevention Branch at the NHLBI. “But patients should talk to their doctor to determine whether this lower goal is best for their individual care.”

To learn more about high blood pressure, see the information on the NIH site.

 

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