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THE QUESTION For people with hypertension, lowering blood pressure to a normal range has proven benefits for heart health. Might lowering it more be even better?
THIS STUDY involved 4,480 men and women who averaged 55 years old and had hypertension but no cardiovascular disease at the start of the study. Over the next 22 years, blood pressure levels were assessed periodically. In that time, 1,622 cardiovascular problems — including heart attack, stroke, heart failure and death related to heart disease — were recorded for the group.
Those whose blood pressure levels remained elevated, with a systolic pressure (the first or top number) of 140 or higher, were most likely to have had a cardiovascular problem, 46 percent more likely than those with a low systolic number. However, people whose blood pressure dropped to a low level, defined as a systolic reading lower than 120, were no less likely to have had a cardiovascular issue than were those who had a systolic blood pressure in the normal range (120 to 139).
WHO MAY BE AFFECTED? People with hypertension (indicated by a blood pressure reading of 140/90 or higher), which increases their risk for heart problems. Efforts to lower blood pressure include changing such lifestyle factors as diet and exercise, taking medication, or both. In the United States, one of every three adults has high blood pressure.
CAVEATS The study did not assess whether the method used to lower blood pressure (medication or lifestyle changes, alone or in combination) had any bearing on the risk for cardiovascular problems.
FIND THIS STUDY June 16 online issue of JAMA Internal Medicine (www.jamainternalmedicine.com).
LEARN MORE ABOUT high blood pressure at www.nhlbi.nih.gov/health and www.heart.org (click on "Conditions").
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.