U.S. Researchers Urge More Aggressive Blood-Pressure Reductions for Older Adults

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September 11, 2015


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Federal researchers are strongly recommending that people 50 and older should consult with their doctors to aim for blood pressure readings significantly lower than what has been the common recommended targets, especially for those under treatment for hypertension.

Their recommendation comes after initial results from a landmark clinical trial sponsored by the National Institutes of Health. It is called the Systolic Blood Pressure Intervention Trial (SPRINT).

The new research advises people 50 and older to keep their systolic blood pressure — the top number in the reading that healthcare providers routinely tell patients — to 120 mm Hg. When the study began in 2009, clinical guidelines called for a systolic blood pressure of 140 mm Hg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes.

The study’s preliminary findings show that medication to keep systolic blood pressure at 120 cut the rate of heart attacks, strokes and heart failure by one third. The trial also found that the risk of death was reduced by nearly 25 percent by keeping systolic blood pressure at 120, compared to the target systolic pressure of 140 mm Hg. Anyone under treatment for high blood pressure should consult with their doctor.

After reaching these conclusions, researchers cut the study short by about a year to release their findings.

“This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of SPRINT.

Gibbons added that researchers “look forward to quickly communicating the results to help inform patient care and the future development of evidence-based clinical guidelines.”

High blood pressure, or hypertension, is a leading risk factor for heart disease, stroke, kidney failure and other health problems. An estimated 1 in 3 people in the United States has high blood pressure.

The SPRINT study, which began in the fall of 2009, includes more than 9,300 participants age 50 and older, recruited from about 100 medical centers and clinical practices throughout the United States and Puerto Rico.

Read other articles related to stroke, heart disease and blood pressure:

— John Fernandez

 

Antibiotics Use May Increase Risk of Type 2 Diabetes

Researchers may have found a potential link between an increased use of antibiotics and the chance of developing type 2 diabetes.

People who receive more than four courses of antibiotics over 15 years are 53 times more likely to develop type 2 diabetes, according to the study published in the Journal of Clinical Endocrinology & Metabolism.

The Danish researchers attribute the link between antibiotics and diabetes to the way antibiotics alter gut bacteria in some people, changing the way they absorb sugar and fat. The changes in metabolism can create insulin sensitivity and glucose tolerance, which lead to diabetes.

The study analyzed data collected from more than 170,500 people who had type 2 diabetes and 1.3 million people who did not have the disease. On average, the type 2 diabetics filled 0.8 prescriptions for antibiotics per year, compared to 0.5 prescriptions a year among the other group.

Nearly one half of U.S. adults have diabetes (12 percent) or prediabetes (38 percent), according to a study published this week in the Journal of the American Medical Association.

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–Tanya Racoobian Walton

 

Too Little or Too Much Sleep Linked to Higher Heart Disease Risk

Poor sleep habits — either getting too much or too little — on a regular basis can put you at a higher risk for heart disease, according to a new study.

Those who get too much or too little sleep — or not enough quality rest — are more likely to develop calcium deposits on the walls of their major arteries, a significant factor in heart disease, said study lead author Dr. Chan-Won Kim, a clinical associate professor in the Center for Cohort Studies at Kangbuk Samsung Hospital in Seoul, South Korea.

The ideal time-frame for sleep appears to be about seven hours a night, the researchers said. People who got more or less sleep tended to have increased signs of potential heart problems in the future.

Several studies have linked inadequate sleep habits with an increased risk of heart attack and stroke, but other conditions such as depression, obesity and diabetes could have an impact on that link.

For the most recent study, more than 47,000 men and women, age 42 on average, completed a sleep questionnaire and had tests to detect lesions of calcium and plaque in the artery leading to the heart, an early sign of heart disease. They were also tested for arterial stiffness in the leg, an indication of vascular aging.

The participants’ average stated sleep duration was 6.4 hours per night, and about 84 percent said their sleep quality was “good.” The researchers considered those who got five hours or less per night to be “short” sleepers, and those who got nine or more hours to be “long” sleepers.

Short sleepers had 50 percent more calcium in their coronary arteries than those who slept for seven hours per night. Long sleepers had 70 percent more calcium than those who slept seven hours.

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— John Fernandez


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