High Blood Pressure
Life Extension has long warned that blood pressure exceeding 115/75 mm Hg can be deadly.1-4 A large study published in 2015 helped corroborate our contention, but also pointed out some important caveats that aging individuals should be aware of before embarking on an aggressive blood-pressure-lowering regimen.
The SPRINT trial results were published November 9th, 2015 in the New England Journal of Medicine.5
This randomized controlled trial that enrolled over 9,300 subjects showed that non-diabetics at increased cardiovascular risk can substantially reduce their risk of cardiovascular events and death by lowering their blood pressure to levels below what were clinical standards at that time.
One group of SPRINT trial participants was intensively treated with blood-pressure-lowering medications to a target systolic blood pressure of less than 120 mm Hg. The other group received medications with a treatment goal of achieving systolic blood pressure of less than 140 mm Hg. The intensively treated subjects took, on average, one additional blood pressure medication compared with the standard treatment group.
The trial was scheduled to last for 5 years, but was stopped after a median of only 3.3 years of follow up because subjects who underwent more intensive blood pressure lowering had a dramatic 25% risk reduction for a composite of cardiovascular outcomes and a 27% lower risk of death from any cause compared with the standard-treatment group.
But while the intensive treatment led to better cardiovascular and overall outcomes, it did increase the risk of kidney problems. As readers of Life Extension publications are aware, aggressive blood-pressure-lowering treatment has the potential to cause side effects, such as impaired kidney function.6,7 We have long recommended regular blood testing to assess kidney function, as well as overall health; this strategy is particularly important for people who undergo aggressive blood-pressure-lowering treatment. By periodically testing one’s glomerular filtration rate, creatinine, and cystatin-C, declining kidney function can be identified in time to initiate preventive measures.
Subsequent to publication of the SPRINT trial results, major shifts have occurred in the conventional interpretation of blood pressure levels. In late 2017, a consortium of prominent medical organizations focused on heart and vascular health released updated guidelines overhauling the definition of high blood pressure.8 The most significant change was that the threshold for overt Stage 1 hypertension dropped from 140/90 mm Hg to 130/80 mm Hg. This change caused millions of additional Americans to suddenly be classified as having high blood pressure.
While we at Life Extension applaud the new guidelines for increasing awareness of the dangers of blood pressure levels previously described only as “prehypertension,” it is disconcerting that it took these major medical organizations this long to lower blood pressure thresholds. Life Extension has advocated a target blood pressure for most people of 120/80 mm Hg for many years, with an optimal level of 115/75 mm Hg for many people.
This protocol outlines a systematic approach to blood pressure control that combines natural interventions—such as quercetin, myricetin and myricitrin, stevioside, and melatonin—and lifestyle strategies with prescription antihypertensive drugs. When coupled with consistent at-home blood pressure monitoring and periodic blood testing to assess kidney function, this approach can help achieve a target blood pressure of 115/75 mm Hg while minimizing risk.