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Blood pressure study just may change your life
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For years, physicians and researchers have searched for the magic number that would answer the question: What blood pressure should you be striving for?

Now, preliminary results from what federal health officials are declaring a "landmark" study suggest that number should be lower than current guidelines.

"I was, frankly speaking, quite surprised," said Alfred Cheung, nephrologist at University Hospital who was one of five principal investigators in the study. He oversaw a clinical network based at the University of Utah that included 17 out of the 100 medical centers that participated in the study.

The SPRINT study, conceived by the National Institutes of Health six years ago, found that patients who achieved a target systolic pressure of 120 or less the top number on a blood pressure reading reduced their incidence of stroke and heart attack by 30 percent compared to those who achieved systolic targets of 140 or less. Those patients also reduced the risk of death by almost 25 percent, officials said.

A systolic blood pressure goal of 120 would be far lower than current guidelines, which are 140 for healthy people and 150 for people aged 60 or older.

But the SPRINT data were so strong that officials ended the intervention more than a year early to distribute the preliminary results, hailing the results as "potentially lifesaving."

Cheung said he could "almost guarantee" that the study will change clinical hypertension guidelines in the U.S., where about one in three adults have high blood pressure and cardiovascular disease remains the leading cause of death.

The study followed 9,300 high-risk patients over the age of 50 with high blood pressure and tracked a number of outcomes, including stroke, heart attack and cognitive and kidney function.

"I truly believe it's a landmark trial," Cheung said. I dont think that there will be a similar trial done like this for a long, long time.

The results go against the current trend toward easing blood pressure targets, said Cheung.

Less than two years ago, prompted by concerns that aggressive medicating was causing dangerous side effects for older adults, an expert panel recommended the target systolic pressure should be relaxed to 150 for adults over the age of 60.

Many doctors and researchers disagreed with the panel, and some organizations like the American Heart Association and American College of Cardiology continued to recommend a systolic target of 140 for those under the age of 80.

In coming months, SPRINT researchers will publish a paper that will address some of the studys caveats. For example, there's still the question of the potential side effects of blood pressure medication, like dizziness or, at worst, loss of cognitive function and kidney function.

Another challenge is whether it's feasible to get patients down to a systolic target of 120.

Thats the problem facing Nancy Childs, 67, who's been dealing with high blood pressure for more than two decades due to polycystic kidney disease.

"That 120/80, for years, that's been the magic number," said Childs.

But she said her blood pressure has fluctuated wildly over the past year as her doctor has tweaked her medication in an attempt to get her down to 120.

On Friday, Childs went to see her doctor after her blood pressure plunged to 91/54. Typically, she said, her systolic pressure hovers around 160 or 170. In past months, it's been as high as 212.

On the piece of paper that comes with her blood pressure medication, Childs has circled all the side effects shes experiencing, including dizziness, fatigue and weight gain.

As her blood pressure has lurched around and the side effects have worsened, Childs said she's gone from being an active swimmer and hiker to being afraid to walk around her neighborhood for fear of falling down.

"I don't like it," she said. "I dont like not being able to do things. As a patient, it's like how do I manage (cysts) getting bigger and my blood pressure and still have a life?"

Deborah Budge, a cardiologist at the Intermountain Medical Center Heart Institute in Murray, said the preliminary results need to be taken cautiously until the full paper comes out. Budge, who is also the board president of the Utah division of the American Heart Association, was not involved in the SPRINT study.

Then the important next step would be each patient to have that individual conversation with their physician based on their own personal risk, she said.

Budget said that particularly in older patients, we always worry about if were trying to be really aggressive, will it increase the risk for falls or other adverse outcomes."

Budge pointed out that the patients in the study had to take an average of three medications to reach a target systolic pressure of 120. Those in the 140 systolic target group took two medications on average.

That kind of shows you its not an easy thing, Budge said. Its not just give them one medication or go up on the dose they actually need three medications.

Still, she said, theres no denying that the findings are big.

"We're talking about the majority of at least the older population (that) this would potentially impact," Budge said.
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