MedicalResearch: What are the main findings of the study?
Dr. Rodriguez: As a clinician there is a notion suggesting that lower blood pressure is better but our current research to date is controversial and not conclusive. We wanted to study a large group of people with hypertension and see whether over 20 years of follow up, if a lower systolic blood pressure would be associated with lower cardiovascular events (heart attack, stroke, heart failure, angina). We hypothesized that there would be a linear association between blood pressure and events, that lower blood pressure would be associated with lower events and that as the blood pressure went up there would be more events. We found this was not the case but that hypertensives with a blood pressure between 120-138mmhg have the greatest benefit and those with a blood pressure less than 120mmhg did not have additional benefit.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Rodriguez: Our study does emphasize that the greatest clinical benefit comes from getting patients below 140mmhg. This was not a treatment study so I do not think it changes treatment but it does bring into question the notion of whether lower blood pressure is better.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Rodriguez: The SPRINT treatment trial is underway to help answer this question and provide a clinical recommendation. We should all participate and support the completion of the SPRINT clinical trial.
Rodriguez CJ, Swett K, Agarwal SK, et al. Systolic Blood Pressure Levels Among Adults With Hypertension and Incident Cardiovascular Events: The Atherosclerosis Risk in Communities Study. JAMA Intern Med. Published online June 16, 2014. doi:10.1001/jamainternmed.2014.2482.