Friday, December 15, 2017
News Roundup

Study points to impact of stricter blood pressure control

Two months ago, U.S. officials crowed that a federally funded study gauging the impact of stricter blood pressure control had produced such dramatic results, they were bringing the clinical trial to an early close.

On Monday, those dramatic results got medicine's version of a ticker-tape parade: a research article and not one but three editorials in the New England Journal of Medicine detailed and dissected just how steeply heart disease, strokes and deaths from any cause declined in patients who aimed to get their systolic blood pressure reading to 120 mm of mercury.

The upshot: For people between 50 and 75 who are at higher than usual risk of cardiovascular disease but don't have diabetes and have not already had a stroke, it's probably no longer defensible to be satisfied with a systolic blood pressure reading just under 140. (Earlier this year, the American Heart Association and American College of Cardiology set a 140/90 mm reading as the correct goal for most patients under 80 years of age with coronary artery disease.)

But getting all such patients' systolic blood pressure readings to 120 may not be entirely realistic either, said experts assessing the significance of the study, called SPRINT (Systolic Blood Pressure Intervention Trial).

Many of the 4,678 subjects assigned to shoot for a systolic reading of 120 couldn't quite make it to that goal, despite an escalation in the number of medications they took and an average increase in such side effects as dizziness, electrolyte abnormalities, and injury to or failure of the kidneys.

Still, the trial's results suggest the benefits of trying were undeniable.

In a follow-up period of just over three years, people between 50 and 75 who make efforts to get that top reading 20 points below 140 mm of mercury reaped a welter of benefits, researchers revealed: Their likelihood of dying of any cause dropped by 27 percent, and they reduced by roughly 25 percent their likelihood of suffering one of a range of cardiovascular outcomes, including heart attack, stroke, heart failure and acute coronary syndrome.

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