How low should your blood pressure go? Doctors have been debating this question for decades. While people with naturally low blood pressure appear to live longer, medications have drawbacks. In addition, older people appear to be more vulnerable to dementia when their blood pressure is too low.
In 2014, experts raised target blood pressure for older Americans. But the SPRINT trial demonstrated that people with lower systolic blood pressures were less likely to have heart attacks. As a result, we are left wondering what is the proper balance between the benefits of blood pressure control and the risks of overmedication?
Determining the Best Level for Blood Pressure:
A new analysis published in JAMA Cardiology demonstrates benefits from lower blood pressure than is currently seen as the target. The researchers evaluated data from 42 randomized clinical trials. All together, those studies included 144,220 patients as participants.
Patients whose systolic blood pressure was between 120 and 124 were only one-third as likely to suffer cardiovascular complications. That is in comparison to people whose systolic blood pressure was at 160 or higher. In addition, they were only about half as likely to die during the study as those with higher pressure.
Even comparisons with people whose systolic blood pressure landed between 130 and 134 showed advantages for those with blood pressure between 120 and 124.
What Is Systolic Blood Pressure?
Systolic blood pressure measures the force the heart exerts while contracting. It’s the higher of the two numbers and is usually first when blood pressure is expressed as, for instance, 120 over 80 (120/80). In this example, 80 is the diastolic blood pressure.
The scientists concluded that most people are at the lowest risk for heart attacks, strokes and death when their systolic blood pressure is between 120 and 124.
Bundy et al, JAMA Cardiology, online May 31, 2017
You and your doctor may need to discuss your risks. That way, you can figure out your blood pressure target. You want to balance your risk of cardiovascular complications against the risk of reactions to antihypertensive medicines. You may wish to read our Guide to Blood Pressure Treatment as you prepare for that conversation.
