研究ers have projected that aggressively lowering 血压 could help prevent more than 100,在美国，每年约有1000人死亡.S. 每年.
"The public health impact of adopting intensive treatment in the right patients is enormous," says 亚当想, 犹他大学 assistant professor of population health sciences.
Bress and his fellow experts from institutions across the country built upon the landmark Systolic Blood Pressure Intervention Trial (SPRINT), which found that decreasing 血压 to less than 120 mmHg compared to 140 mmHg reduced heart attack, stroke and death in people that were at high risk. But — until now — the potential number of lives that could be saved if SPRINT-based intensive treatment were fully implemented among eligible U.S. 成人是未知的.
The 犹他大学-led team of researchers used data from the National Health and Nutrition Examination Survey from 1999 to 2006 conducted by the National Center for Health Statistics. 运用科学的调查设计, 他们专注于2,000 men and women who met the SPRINT eligibility criteria to determine the projected 107,每年拯救500人的生命.
在美国，吸烟是导致死亡的主要原因.S. 是心脏病. In past decades, doctors had typically worked to keep patients' 血压 低于140毫米汞柱. SPRINT concluded that there could be a 27 percent reduction in mortality through the intensive 血压 regimen.
"The lifetime risk of high 血压 in the US is about 80 percent," says the study's senior author Richard Cooper, professor and chairman of Public Health Sciences at Loyola University Medical School, 谁和布雷斯合作过. "Optimal management is one of the most significant contributions of medical care to patient survival. So we need to understand that small improvements in individual management can make a major impact on people's health."
To achieve 血压 of 120 mmHg or less, it's likely people would need to take three or four medications instead of two recommended for the higher 血压 goal, 助理教授说. They would likely also see the health care provider more frequently and need more lab tests. Though this would require some additional spending in the short-term, the overall cost of high 血压 in the U.S. 大.
"Currently about 80 million Americans have higher 血压: one out of three," Bress says. "And the treatment cost of 高血压 is about $80 billion a year."
The medications doctors would need are already available, safe, effective, and inexpensive, he added. In some individuals they cause side effects such as fatigue, cough and lower leg swelling.
布雷斯是《Potential Deaths Averted and Serious Adverse Events from the adoption of the SPRINT Intensive Blood Pressure Regiment in the U.S." 该杂志将于2月11日在网上发布. 13在杂志上， 循环.
He acknowledges that some concerns remain about dropping 血压 so dramatically. Their analysis also showed that additional 血压 medications increase risk for low 血压, 晕倒, 急性肾损伤. Currently, scientists are investigating whether the treatment impacts cognition.
"The point we're trying to make when it comes to choices around intensive treatment is: Do the benefits of reducing your risk of stroke or early death outweigh the risks?布雷斯说。.
Cooper believes the treatment goal for systolic 血压 should be reset to at least 130. Practical trials should be created to help monitor 血压 at home and find systems -- such as electronic recording -- that make it easier for doctors to meet that target, 他说.
Additional research is underway to determine who may best benefit from SPRINT protocol -- whether that is someone who is of a certain age group, or someone that does not have diabetes or other conditions.
Bress and the researchers analyzed data from individuals who met SPRINT eligibility: they were of age 50 or older, at high risk of cardiovascular disease and without a history of diabetes or stroke.
How to implement the reduced 血压 protocol also remains a question mark, Bress said. But he doesn't think there should be a delay.
"What I fear is that if it takes 10 years to implement, we would not fully realize the potential public health gains. Within that time we could greatly reduce the number of deaths from high 血压."
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The research was supported by the National Heart, Lung, and Blood Institute.
In addition to Bress and Cooper, co-authors are Srinivasan Beddhu, Alfred K. Cheung, and Rachel Hess (犹他大学); Holly Kramer, Rasha Khatib, Vinod K. 邦萨尔, Guichan曹, and Ramon Durazo-Arvizu (Loyola Medical Center); Jerry Yee (Henry Ford Hospital); Andrew E. Moran (Columbia University Medical Center); and Paul Muntner (University of Alabama at Birmingham).
——茱莉亚·里昂撰写