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Lowest blood pressure is 'not best' for reducing CVD risk

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Low blood pressure is not necessarily best when it comes to preventing heart attacks and strokes, new US research suggests.

A study that turns conventional thinking on its head shows that in at-risk patients, a cut-off point is reached below which further reductions in blood pressure provide no added benefit.

“This calls into question the notion that lower is better”

Carlos Rodriguez

Researchers looked at data from 4,480 patients with high blood pressure taking part in a heart disease study.

Over a period of 21 years, participants had their systolic blood pressure - the blood circulation pulse coinciding with each heart beat - measured at three year intervals.

At the same time, cases of heart failure, heart attack, stroke, or death associated with heart disease were recorded.

The study found that lowering systolic blood pressure below 140mmHg was beneficial. But reducing it still more to below the “normal” figure of 120 mm Hg had no further impact on the rate of cardiovascular events.

Lead author Dr Carlos Rodriguez, from Wake Forest Baptist Medical Center, said: “Frequently we treat patients’ blood pressure to the lowest it will go, thinking that is what’s best.

Wake Forest

Carlos Rodriguez

“Our observational study found that treating to low pressures doesn’t provide any benefit to patients with regard to reducing risk of dangerous heart events like heart attack, heart failure and stroke. This calls into question the notion that lower is better.”

The findings are published in the online edition of the journal JAMA Internal Medicine.

Previous research has documented a progressive increase in heart disease risk as systolic blood pressure rises above 115 mm Hg.

Patients in the study were classified as having systolic blood pressure that was “elevated” (140 mm Hg or greater), “standard” (120 - 139 mm Hg), or “low” (less than 120 mm Hg).

The scientists took account of influencing factors such as age, gender, diabetes, body mass index, cholesterol level, smoking and alcohol consumption.

Dr Rodriguez added: “Our study found that the optimal blood pressure range for people with hypertension is 120-139, which significantly reduces the risk of stroke, heart attack or heart failure.

“These findings suggest that you don’t need to go lower than that to have the benefits.”

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Readers' comments (1)

  • It is the national guideline that everyone should have normal B/P readings. If your B/P reading is elevated above the normal limits your are told to reduce the B/P either by drugs or lifestyle change. The same with Cholesterol levels. Each patient should be treated individually and not follow the national limits. Surely it is the duty for the Doctors who should determine the normal B/P for each of the patient and see what is best to suit each patient.

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