More Aggressive Control of Blood Pressure Modestly Extends Life in Older People

Hypertension, the widespreak age-related increase in blood pressure, is very damaging. It is one of the major ways in which low-level biochemical damage, leading to stiffening of blood vessels and consequent disruption of the feedback mechanisms that determine blood pressure, gives rise to structural tissue damage throughout the body. Hypertension harms delicate tissues in the brain, kidneys, and elsewhere. Hypertension also speeds the development of atherosclerosis, the formation of fatty lesions in blood vessel walls, and makes it more likely that blood vessels weakened by plaques will rupture, leading to a heart attack or stroke. These and other mechanisms are why control of blood pressure, without controlling the underlying causes of hypertension, has a measurable effect on life expectancy.

Globally, an estimated 1.13 billion people have high blood pressure, or hypertension, which causes about 13% of all deaths, according to the World Health Organization. Almost 1,000 people in the U.S. die each day with high blood pressure as a primary or contributing cause, according to data from the Centers for Disease Control and Prevention. The research into hypertension care and life span found that with more intensive blood pressure control, focused on a target systolic blood pressure of less than 120 mmHg, a 50-year-old could expect to live almost three years longer. In order to achieve the lower blood pressure target, patients adopted healthy lifestyle habits and took blood pressure medications as prescribed.

At age 65, intensive treatment could extend life by more than a year, the research estimated. With intensive treatment, an 80-year-old would be expected to add almost 10 months to his or her life span. The new study builds on the 2015 findings of the landmark Systolic Blood Pressure Intervention Trial, or SPRINT, which tested the value of treating blood pressure intensively to reduce systolic readings to a lower target - below 120 mm Hg, instead of the routinely used target of below 140 mmHg. SPRINT, which followed patients for up to six years, found that the intensive approach reduced patients' risk of cardiovascular events by 25%. These events included heart attack, stroke, heart failure and cardiovascular-related death.

In this analysis, SPRINT data was evaluated to project the full life spans for patients treated intensively to meet the lower blood pressure target of 120 mmHg and for those who received standard care (systolic blood pressure target of less than 140 mmHg). Across age groups, intensive treatment for high blood pressure lengthened patients' remaining life span by 4% to 9%, compared with standard care, the study found.

Link: https://newsroom.heart.org/news/studies-explore-potential-benefits-and-costs-of-increased-treatment-to-achieve-lower-blood-pressure-targets

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