intensive blood pressure

Intensive blood pressure management improves health outcomes of high-risk patients

High blood pressure is something most people don’t think about, as its symptoms usually go unnoticed until the damage is already done. Heart attacks, stroke, and even brain aneurysms all have links to high blood pressure.

About 75 million Americans have high blood pressure and only half have their condition under control. In 2014, more than 400,000 Americans died due to high blood pressure complications.

Improving patient health

While guidelines for lowering blood pressure do exist and have proven to be effective, two new studies suggest that more intensive goals for lowering blood pressure are well tolerated and cost-effective in terms of health-related quality of life and costs to the health care system.

The standard guideline is to keep systolic blood pressure below 140mmHg. These new studies provide evidence that targeting an even lower pressure of 120mmHg is better.

“In treating a chronic condition such as hypertension, it is important not only to prevent cardiovascular morbidity and mortality such as heart attacks and stroke but also to ensure that people under treatment continue to feel well,” says the second study’s lead author Dan Berlowitz.

One of the studies looked at 9,631 participants and their health-related quality of life, about half of which were on intensive blood pressure therapy. They were asked questions assessing quality of life, physical and mental health, and their overall satisfaction with care during the study.

Those following an intensive treatment regimen reported feeling as well as those receiving standard blood pressure control. Medications were well tolerated and they were more likely to maintain their medication regimen. Even frail participants over the age of 75 fared well with intensive high blood pressure treatment.
While aiming for a blood pressure below 120mmHg would be ideal for high blood pressure patients, the researchers stress that this may not necessarily be for everyone. Patients and their doctors need to work closely together to help keep an eye on symptoms, helping to maintain their current health-related quality of life.

The cost of improving health care

One concern is the increased cost that intensive high blood pressure management would require. More doctor visits, additional medications, and extra lab tests are all expenses that would have to be factored into the overall cost of making this type of change. However, the researchers express that if this type of intense blood pressure regimen were to be implemented, the costs associated would be balanced by the gain in health, being cost-effective in the long run.

“Intensive blood pressure treatment prevents heart disease, but it requires extra effort from patients and health care providers. Our study showed that it is a very good value if the treatment is sustained long-term,” says co-senior author Andrew Moran.

Related: Essential oils for high blood pressure and how to use them


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http://www.nejm.org/doi/10.1056/NEJMoa1611179
http://www.nejm.org/doi/10.1056/NEJMsa1616035
https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm

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