While the results of new National Institutes of Health study on blood pressure management could help reduce cardiovascular disease and save lives, questions on the data and its implementation remain, according to one UNC Charlotte expert.
The NIH research found targeting a lower blood pressure than previously recommended in high risk patients ages 50 and up led to a significant drop in cardiovascular events and stroke, and reduced the risk of death by a quarter.
Researchers carefully adjusted the medicines some participants were taking to achieve a target systolic pressure of 120 millimeters of mercury (mm Hg), and compared outcomes with another group of subjects whose target was the traditionally recommended 140 mm Hg.
Dr. Jan Warren-Findlow, an associate professor and cardiovascular disease researcher at UNC Charlotte, said she was “conflicted” after seeing the results.
“We've known for a while that systolic blood pressure below 120 may be a preferable threshold, but clinicians have typically not been prescribing medication for patients in the gray zone between 120-140. So this study may provide the evidence-base to start medication therapy for literally millions of people, potentially helping them.”
Yet Warren-Findlow says applying the finding isn’t as simple as dishing out some additional medications.
“The devil is in the details. I would like to see how well this intervention worked among the various patient sub-groups based on race, ethnicity, gender and so forth,” she said. “Further, patient-participants were on an average of three medications, were these generics or newer, patented drugs? That has a lot of cost implications for society and the individual.”
Additional details on the study, such as which specific medications were used, will be available in the coming months.
High blood pressure is a leading risk factor for heart disease, stroke, kidney failure, and a range of other health problems. An estimated 1 in 3 people in the United States has high blood pressure, according to NIH.
Given those numbers, Warren-Findlow said the impact on public health could be significant. However, she repeated concerns about deploying increased prescription medicine programs.
“People are not eager to take medications, particularly if they don't feel ill. This is especially true of African Americans, the primary group with whom I work. Although the threat of needing medication may also encourage people to engage in more healthy behaviors (smoking cessation, losing weight, increasing physical activity, reducing salt intake) that would reduce their blood pressure and perhaps allow to avoid taking medications.”
Over the course of the research, participants in the 120 mm Hg group took an average of three medications, while the control group took an average of two.
Researchers from the NIH study are also looking at the effect of the reduced target blood pressure on kidney disease, cognitive function and dementia.
by: Wills Citty