High Blood Pressure Research

• NHLBI’s Systolic Blood Pressure Intervention Trial (SPRINT) found that treating to a lower systolic blood pressure target — less than 120 mm Hg — helped lower deaths from heart attack and stroke, particularly among older people who have high blood pressure. These findings informed the latest high blood pressure guidelines published in 2017. A follow-up study called SPRINTMIND found that this lower blood pressure target also reduced mild cognitive impairment, a condition that can lead to dementia. Visit Intensive blood pressure control may slow age-related brain damage for more information. 
• The Dietary Approaches to Stop Hypertension (DASH) Sodium Trial showed that reducing sodium as part of a healthy eating plan substantially lowers blood pressure in persons with high blood pressure. The greatest effect was seen when sodium reduction was combined with a diet that is rich in fruits and vegetables and low in saturated fat and that was previously shown to lower blood pressure, such as with the DASH Eating Plan.
• The NHLBI Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was the largest hypertension clinical trial ever conducted, involving more than 600 clinics and 42,000 participants. The study compared the success of three commonly used blood pressure-lowering medicines (a calcium channel blocker amlodipine, an ACE-inhibitor lisinopril, and an alfa-receptor blocker doxazosin) with a diuretic, chlorthalidone. The trial concluded that the diuretic worked better than the other medicines to manage high blood pressure and prevent stroke, as well as some types of heart disease, especially heart failure.

Our Division of Cardiovascular Sciences and its Vascular Biology and Hypertension Branch oversee much of the research we fund on the regulation of blood pressure.

Current research on the treatment of high blood pressure

NHLBI-supported research has contributed to blood pressure treatments that have helped people around the world. High blood pressure affects millions of U.S. adults. We continue to support work on new treatments and new approaches to tailoring the right treatment for the right patient.

• Researchers at the NHLBI-funded Levy Lab are studying the role of genetics in cardiovascular disease, using resources from the Framingham Heart Study to develop promising blood pressure medicines and treatments.
• The NHLBI funds research into the connection between inflammation and high blood pressure. Better understanding of the causes of hypertension will help researchers develop treatments to improve blood pressure management and prevent early death from cardiovascular disease.
• The NHLBI supports research that improves adherence to long-term cardiovascular medicines that help to regulate blood pressure. Researchers will use pharmacy data to identify patients who fail to refill their medicines. They will then test whether reminders using text messages or interactive chat bots can help improve medicine adherence.
• The NHLBI funds research into the connection between microbiome and high blood pressure. One recent study showed that intermittent fasting in an animal model could reduce hypertension by reshaping the gut microbiota.
• Findings from the Offspring Cohort of the Framingham Heart Study (FHS) and the Coronary Artery Risk Development in Young Adults (CARDIA) study showed a close association between hypertension and late-onset epilepsy and other brain changes, respectively, which may increase the risk of cognitive decline later in life.
• A clinical trial called Treating Resistant Hypertension Using Lifestyle Modification to Promote Health (TRIUMPH), showed that lifestyle modification, such as by following the DASH eating plan, could significantly reduce blood pressure even in patients with resistant hypertension.
• A clinical trial, Chlorthalidone in Chronic Kidney Disease (CLICK) showed that the diuretic chlorthalidone can improve blood pressure control in patients with advanced chronic kidney disease. 
• A recent meta-analysis showed that the use of blood brain barrier-crossing ARBs and ACE-inhibitors was linked to better cognitive benefits. Supported by R01 HL080477 and T32 HL07594.

Find more NHLBI-funded studies on the high blood pressure treatment at NIH RePORTER. 

Find out more about how the DASH diet and exercise help fight resistant high blood pressure.

NHLBI in the Press

Find out more about how the DASH diet and exercise help fight resistant high blood pressure.

Current research on women’s health and high blood pressure

NHLBI-supported research has helped reveal how pregnancy complications, including high blood pressure, affect the long-term health of women and their children.

• One study links preterm pregnancy to a greater chance of high blood pressure in women.
• Another study shows that women in their first trimester of pregnancy who also have higher blood pressure, high levels of glucose, insulin, or triglycerides, or obesity were more likely to experience adverse pregnancy outcomes such as gestational hypertension or diabetes, preeclampsia, or pre-term delivery. That same study also showed these women also had a higher risk of hypertension years after delivery.
• The NHLBI Maternal Morbidity and Mortality (3M) Administrative Coordinating Center identifies and prepares community-based organizations to help improve the health of pregnant women who are at higher risk of maternal death and disease.
• The NHLBI continues to fund the nuMoM2b Heart Health Study, which helps scientists understand how cardiovascular disease starts and develops in women. The study, funded by the NHLBI and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, is now looking at the links between pregnancy, sleep health, and cardiovascular health.
• NHLBI’s CHAP Maternal Follow-up Study examines the impact of treatment for preeclampsia and high blood pressure during pregnancy on a woman’s future chance for developing cardiovascular disease. The results will help identify the best ways to improve the health of women younger than 40 who have mild, long-term high blood pressure.
• Another NHLBI-supported study uncovered a link between infants who had heart surgery early in life to correct a congenital heart defect, and high blood pressure in adulthood.

Find more NHLBI-funded studies on women’s health and high blood pressure at NIH RePORTER. 

Current research on health disparities and high blood pressure

African American and Hispanic adults in the United States have a higher prevalence of high blood pressure than other racial and ethnic groups. The NHLBI supports research to understand and lower high blood pressure disparities, as part of our broader commitment to addressing health disparities and inequities.

Other studies and research areas we fund to lower the burden of health disparities are listed below.

• Our RURAL: Risk Underlying Rural Areas Longitudinal Cohort Study reaches 4,000 young and middle-aged men and women from different racial and ethnic groups living in poor rural counties in four southern states. The goal of the study is to understand what causes the high rate of heart and lung disease in these regions and how to improve and prevent it.
• An NHLBI-funded study is comparing clinic-based care with a collaborative care team/stepped care approach. The collaborative care/stepped care approach, which includes education outreach by community health workers and consultations with specialists, is designed to help lower high blood pressure and heart disease risk among minorities, poor people, and people living in rural areas.
• An NHLBI-funded study aims to improve high blood pressure in African American people in the Black Belt area of Alabama. The study includes 2,000 African American people who have uncontrolled high blood pressure. The study findings will help to eliminate barriers to blood pressure treatment faced by this group.

Find more NHLBI-funded studies on high blood pressure and health disparities at NIH RePORTER. 

Research Feature

An NHLBI-funded study used barbershops as a venue for helping Black men lower their blood pressure.

The NHLBI Division of Intramural Research and its Cardiovascular Branch conduct research on diseases that affect the heart and blood vessels, including high blood pressure. Other Division of Intramural Research groups, such as the Center for Molecular Medicine and Systems Biology Center, perform research on heart and vascular diseases.

• NHLBI’s recently launched Disparities Elimination through Coordinated Interventions to Prevent and Control Heart Disease Risk (DECIPHeR) program to work with local communities to study different proven interventions for hypertension. In Los Angeles, 51 adult primary care clinics will use culturally tailored strategies to improve blood pressure management in this large, diverse city.
• The Chronic Hypertension and Pregnancy (CHAP) trial is examining the safety and success of medication to treat mild high blood pressure during pregnancy.
• In 2018, the NHLBI, in collaboration with NICHD, held a workshop on Predicting, Preventing and Treating Preeclampsia. Experts developed many recommendations, including new treatment strategies, for dealing with the condition, which is caused by a sudden spike of blood pressure during the second half of pregnancy.

In 2019, the NHLBI convened the HIV-associated Comorbidities, Co-infections & Complications Workshop, which resulted in strategies to support more research into the diseases, infections, and complications related to HIV. People with HIV have a higher risk of developing high blood pressure, whether or not they actively take their HIV medicine.