Doctors should more intensively manage hypertension for adults over 50, aiming for blood pressure targets well below current guidelines, according to preliminary results of a landmark clinical trial sponsored by the National Institutes of Health.
Adjusting medication to achieve systolic pressure of 120 mm Hg instead of the current recommendation of 140 mm Hg significantly reduced rates of cardiovascular disease, and lowered risk of death in a group of adults 50 years and older with high blood pressure, according to results of the Systolic Blood Pressure Intervention Trial (SPRINT).
The Tulane University School of Medicine was one of the clinical sites for the study, which is the largest to examine how maintaining systolic blood pressure at a lower level will affect cardiovascular and kidney diseases.
“This finding is very important because it will change our daily clinical practice in hypertension management,” says Dr. Jing Chen, an associate professor of medicine who is principal investigator of the Tulane study site with Dr. Jiang He, Joseph S. Copes Chair of Epidemiology in the School of Public Health and Tropical Medicine.
The study followed more than 9,300 hypertension patients randomly divided into two groups. One received standard care and the other got more intensive medication to achieve a target of less than 120 mm Hg. The intensive group had their risk of heart attacks and strokes reduced by 30 percent and risk of death reduced by 25 percent.
Epidemiology professor Dr. Paul Whelton, who is chair of the national steering committee for the study, says, “Individual patients should consult with their primary healthcare provider to determine how our results should influence their treatment. Some healthcare providers may recommend more intensive blood pressure reduction at this time, but others may wish to see more details.”
Dr. Tonette Krousel-Wood, epidemiology professor and associate provost for the health sciences, led the city’s second trial site at Ochsner Health System.