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Understanding High Blood Pressure
Researchers Find Lower Isn’t Necessarily Better, and Women Face Greater Potential Danger

photoWake Forest Baptist researchers are helping to clarify risks associated with high blood pressure.

Results from one study are challenging common medical wisdom that “the lower the better” should be the guideline for treating the approximately one in three people in the United States who have high blood pressure.

The study, published online in JAMA Internal Medicine, looked at reducing risk for dangerous heart events. Wake Forest Baptist researchers found that lowering systolic blood pressure (the top number in a standard blood pressure reading) below 120 does not appear to provide additional benefit for patients when it comes to reducing risk of dangerous heart events like heart attack, heart failure and stroke.

Carlos J. Rodriguez, MD, associate professor of public health sciences and the study’s lead author, said doctors frequently treat patients’ blood pressure to the lowest it will go, thinking that is what’s best.

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

photoHe noted that a large clinical trial under way called SPRINT (Systolic Blood Pressure Intervention Trial) should either confirm or refute the findings.

A separate study, published in the journal Therapeutic Advances in Cardiovascular Disease, found for the first time significant differences in the mechanisms that cause high blood pressure in women as compared to men, and that high blood pressure is potentially more dangerous for women.

“The medical community thought that high blood pressure was the same for both sexes, and treatment was based on that premise,” said Carlos Ferrario, MD, professor of surgery and lead author of the study. “This is the first study to consider sex as an element in the selection of antihypertensive agents or base the choice of a specific drug on the various factors accounting for the elevation in blood pressure.”

In a comparative study of 100 men and women age 53 and older with untreated high blood pressure, the researchers found 30 to 40 percent more vascular disease in the women.

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