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    Small Increases in Blood Pressure Raise Heart Death Risk

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    MacMahon notes that small changes in blood pressure across an entire population -- such as those that could be achieved by reducing salt or calorie intake -- would save a very large number of lives.

    Laurence Sperling, MD, FACC, FACP, director of preventive cardiology at Emory University Medical Center in Atlanta, agrees. "To me, it's not a surprise that a small difference in blood pressure can make a big difference in risk of cardiovascular disease," Sperling tells WebMD in an interview to provide objective comment. "A lot of people have felt, 'If my blood pressure is not super-high, I'm not at risk of stroke today.' But we know there is a cumulative effect of walking around with high blood pressure for a long time. We should work toward optimal blood pressure. Optimizing blood pressure is a difficult thing to achieve. It takes a lot of hard work and diligence on the part of both physician and patient. It is something everyone has to work at very hard."

    To lower one's blood pressure, Sperling advises appropriate medical treatment, sodium restriction, weight loss, exercise, and minimal alcohol consumption.

    MacMahon stresses the need to recognize that blood-pressure-related disease affects many more people than previously thought. "Lifestyle changes should be considered across the board for individuals at risk," he says. In regard to medications, he states that most blood pressure-lowering drugs are still limited to those with diagnosed hypertension. More clinical trials are needed to investigate the use of blood-pressure lowering drugs on others at risk for blood-pressure-related diseases.

    Such studies should begin as soon as possible, MacMahon argues. He notes that single-drug treatment with most available agents lowers blood pressure by only 5-10%. Although drug combinations or new drugs can increase this action by about half, new drugs urgently are needed.

    "There is the potential to avoid millions of unnecessary deaths, heart attacks, and strokes each year by the development of more effective treatments for blood-pressure reduction," he says.

    Vital Information:

    • Small increases in blood pressure raise the risk of death from coronary heart disease, even in those who are not diagnosed with high blood pressure.
    • To lower blood pressure, experts advise medical treatment, sodium restriction, weight loss, and limited alcohol consumption.
    • Blood pressure medications are currently approved only for those who have diagnosed high blood pressure, but further study is needed for others who are at risk for blood pressure-related diseases.
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