Blood Pressure Guidelines Challenged

Systolic blood pressure guidelines may need to be lower to prevent more strokes

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Stop the presses! New evidence has challenged a previous guideline for recommended blood pressure levels.

The authors of a new study said that patients' systolic blood pressure (top number) should be 140 millimeters of mercury (mm Hg), instead of the previously advised 150 mm Hg. This lower threshold may lower the risk of stroke in some patients.

Chuanhui Dong, PhD, of the University of Miami's Miller School of Medicine, led this study.

“This implies blood pressure from 140-149 is just as strong of a stroke risk factor as levels of 150 and greater,” Dr. Dong said in a press release.

A 2014 JAMA report advised doctors to shoot for blood pressure readings of lower than 150 over 90 mm Hg. This guideline was for treating patients who were 60 or older and who did not have chronic kidney disease or diabetes.

But Dr. Dong and team found that the risk of stroke was 70 percent higher for those with systolic blood pressures ranging from 140 to 149. This was in comparison to those with systolic blood pressures below 140.

These researchers noted that the 70 percent increased risk was close to the 80 percent higher risk for people with systolic blood pressures at or above 150.

Compared to people with systolic blood pressures below 140, Hispanics with systolic blood pressures between 140 and 149 had 2.4 times the risk of a first-time stroke. They also found that blacks with systolic blood pressures of 140 to 149 had twice the risk of first stroke. Whites showed no difference in raised risk, but Dr. Dong and team noted that this may be due to having too few whites in this study.

The authors said the difference in risk among women was also surprising. First-time stroke risk nearly doubled in women who had a systolic blood pressure of 140 to 149 — compared to those below 140.

A stroke occurs when blood flow to the brain is blocked. High blood pressure is a well-known risk factor for stroke.

Many lifestyle habits can lower blood pressure. These include a healthy diet, exercise and not smoking. Medications called antihypertensives can also treat high blood pressure.

This study was published Feb. 11 in the journal Stroke. It was presented Feb. 11 at the American Stroke Association's annual meeting in Nashville, TN.

Study author Dr. Mitchell S. V. Elkind was a consultant and/or on the advisory board for various pharmaceutical companies. None of the other authors had financial disclosures or conflicts of interest to report.

Review Date: 
February 11, 2015
Last Updated:
February 14, 2015