Have high blood pressure? Here’s how to lower your risk of heart attack and stroke

Intensive efforts to bring down high blood pressure can lower the risk of heart attack and stroke, a new study has found.

High blood pressure, also known as hypertension, is a common health issue affecting an estimated 1.28 billion adults ages 30 to 79 worldwide. Left untreated, high blood pressure can cause heart disease, stroke, and kidney disease.

Doctors often advise hypertension patients to take medication and make lifestyle changes, such as regular exercise and a healthy diet, to lower their systolic blood pressure to around 140 mmHg.

Systolic blood pressure is the higher of the two numbers in a reading, reflecting the pressure in the arteries when the heart is pumping blood. A level of 140 mmHg is considered high blood pressure, but it is on the lower end of the hypertension spectrum.

The new study, published in The Lancet medical journal, indicates that intensive blood pressure control – taking steps to lower systolic blood pressure even further, to below 120 or 130 mmHg – can reduce people’s risk of major heart problems such as heart attack and stroke.

The findings come amid debate in the medical community over exactly how low people should aim to bring their blood pressure. Some experts fear that aggressive blood pressure control could raise the risk of falls among older adults, for example.

The Chinese research team behind the study said it is the most extensive analysis to date on how this approach affects people’s health.

The researchers analysed data from about 80,000 people who participated in six clinical trials testing blood pressure control methods in China, Canada, and the United States.

They found that across the trials, people who went the intensive control route – a combination of medication and lifestyle changes such as weight loss and quitting smoking – had fewer heart attacks, strokes, and cardiovascular-related deaths than people who were treated with standard blood pressure goals.

Notably, however, the intensive control group was more likely to experience side effects such as dizziness, fainting, kidney problems, and abnormal heart rhythm.

The results suggest there’s a “net benefit” to intensive blood pressure control, the study authors said.

They recommended that doctors take a nuanced approach that takes into account each of their patients’ circumstances, and said the findings “underscore the importance of individualised strategies to optimise outcomes while avoiding both overtreatment and undertreatment”.