Q1: What is the significance of the systolic number in a blood pressure reading?
A: A blood pressure reading involves two numbers, one over the other. The top number is the systolic number and the bottom number is the diastolic number. For example, a reading might be presented as 120/80 millimeters of mercury (mm Hg).
Systolic pressure, the top number, is the pressure on the arteries when the heart beats and pumps blood through the arteries. Diastolic pressure, the bottom number, is the pressure when the heart is filling with blood between beats. Although both systolic and diastolic measures are important, research has found that systolic pressure is a strong predictor of vascular problems caused by high blood pressure, especially among older adults.
Q2: What can patients who are age 50 and older and have high blood pressure do to control their blood pressure and reduce their risk for heart disease and stroke?
A: The 2015 results of the SPRINT trial showed that, in adults age 50 and older with high blood pressure, targeting a systolic blood pressure of less than 120 millimeters of mercury (mm Hg) reduced rates of cardiovascular events, such as heart attack, heart failure, and stroke, by 25 percent. Additionally, this target reduced the risk of death by 27 percent, compared with a target systolic pressure of 140 mm Hg. A systolic reading of 140 mm Hg was the commonly recommended target at the time that the SPRINT trial was conducted. Based on these and other findings, the American College of Cardiology (ACC) and the American Heart Association (AHA) released new comprehensive high blood pressure guidelines in November 2017. The new ACC/AHA guidelines were published in the Journal of American College of Cardiology and Hypertension. The new guidelines now define high blood pressure as systolic readings of 130 mm Hg or higher or diastolic readings of 80 mm Hg or higher. This is a change from the old guideline definition for high blood pressure, which was 140/90 mm Hg and higher.
If you have high blood pressure, you’ll need to treat it and control it. This means making lifestyle changes, taking prescribed medicines, and getting ongoing medical care. You should consult your doctor or other healthcare provider to discuss the best treatment options for your condition.
Q3: Could managing blood pressure differently save lives?
A: The SPRINT trial found that by carefully adjusting the amount or type of blood pressure medicine to achieve a systolic pressure of 120 mm Hg, it should be possible to reduce rates of heart attack and heart failure by almost one-third and the risk of death by almost one-quarter, compared with maintaining a systolic pressure of 140 mm Hg. Analysis showed that treating to the lower blood pressure target also is cost-effective.
Q4: How do doctors get the information that is needed to manage blood pressure effectively based upon this research?
A: Healthcare providers will be encouraged to pay attention as clinical guidelines groups consider the issue based on this and other studies. Ultimately, doctors will need to make treatment decisions based on each patient’s unique medical history.
Q5: How can I get information about the medicines used in SPRINT?
A: To learn more about the medicines and the treatment algorithm used in SPRINT, please visit the SPRINT trial website. There you can also find details about the trial’s specific approach to intensive blood pressure control in participants, the treatment algorithm, and the SPRINT formulary.
Q6: Besides blood pressure medicines, what are some other steps patients can take to control blood pressure?
A: In addition to taking medicines to reduce high blood pressure, patients can take other steps to prevent the long-term problems that high blood pressure can cause. Patients can follow healthy lifestyle habits such as choosing a heart-healthy eating pattern including the DASH eating plan, being physically active, maintaining a healthy weight, quitting smoking, and managing stress. A healthy lifestyle can also help prevent high blood pressure in children and teens.
Q7: What’s a good source of additional information on high blood pressure?
A: The National Heart, Lung, and Blood Institute is a valuable source of information on high blood pressure.