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Dec 07, 2018

Stricter Blood Pressure Guidelines Could Save Millions of Lives, Study Finds

National analysis highlights the risks and benefits of tighter blood pressure guidelines.

More aggressive blood pressure guidelines could prevent up to 3 million heart events over ten years, based on a recent analysis published in the American Heart Association journal Circulation. The study estimated the potential impact of new 2017 blood pressure guidelines released by the American College of Cardiology and American Heart Association and highlights the pros and cons of more aggressive treatment.

In 2017, the American College of Cardiology and American Heart Association rolled out new guidelines that expanded eligibility for blood pressure treatment. Recommendations for treatment are based on a combination of average blood pressure level and risk for heart disease. And the new guidelines lowered treatment goals to a recommended target of less than 130/80 mmHg.

Together, these changes would result in an estimated 4.2 million U.S. adults qualifying for blood pressure medication. They would also increase the number of adults exceeding the treatment target by nearly eight million compared to previous guidelines.

In the recent study published in Circulation, experts looked at how these updates could ultimately affect public health. The analysis included data from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke), which tracked the health and blood pressure of more than 30,000 U.S. adults over 45 years of age from 2003 and 2007. The analysis also used data from the National Health and Nutrition Examination Surveys (NHANES) to apply data to the overall U.S. population.

What researchers found is that the new 2017 guidelines could prevent 3 million heart events over ten years compared with current blood pressure levels. The new guidelines also outperform current guidelines, potentially preventing 1.4 million additional heart events compared to 2014 Eight Joint National Committee goals.

The catch? Researchers also found that the tighter 2017 blood pressure goals could lead to nearly 3.3 million more serious adverse events over ten years. There are a number of different medications used to lower blood pressure, such as beta blockers and ace inhibitors. All medications have some risk of adverse events and treatment options are always weighed with these potential risks in mind.

Based on findings, there are both risks and benefits to tighter blood pressure guidelines in the general U.S. population. Blood pressure currently affects an estimated one in three American adults, increasing risk for heart attack, stroke and other complications. As projections show, more aggressive treatment could help prevent millions of heart events while increasing risk for negative consequences as well.

What findings highlight, according to experts, is the importance of identifying patients who stand to benefit most from treatment and have lower risk of complications. While aggressive blood pressure treatment can better reduce risk for heart events, those benefits should always be weighed against any risk of complications.

Questions for You to Consider

  • What is hypertension?
  • Hypertension, often referred to as high blood pressure, occurs when the force of blood against the artery walls is too high. High blood pressure is often referred to as the “silent killer,” because it often causes no symptoms and if left uncontrolled, increases risk for heart attack and stroke.
  • What is a healthy blood pressure?

  • For adults, a healthy blood pressure is less than 120/80 mmHg. Blood pressure is considered elevated between 120–139 mmHg systolic (top number) or between 80–89 mmHg diastolic. Chronic high blood pressure, known as hypertension, occurs when systolic blood pressure is more than 140 mmHg or the diastolic systolic blood pressure is more than 90 mmHg.

Infographic: High Blood Pressure


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