Controlling Blood Pressure Lengthens Lifespan

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A new analysis of results from the SPRINT trial finds that across age groups, intensive blood pressure control may lengthen a person’s lifespan by 4-9 percent.

"High blood pressure has been implicated as one of the reasons for stalled progress in reducing heart disease-related deaths in the United States," said Muthiah Vaduganathan, M.D., MPH, Brigham and Women's Hospital, Boston in a news release issued by the American Heart Association (AHA). Dr. Vaduganathan is the study’s lead author. "These data reinforce that tighter blood pressure control, especially when started earlier in life, may meaningfully prolong life span."

The findings were presented during the AHA's Scientific Sessions annual meeting that took place November 16-18 in Philadelphia.

The Systolic Blood Pressure Intervention Trial (SPRINT), which was published in 2015, showed that intensive blood pressure (BP) control (systolic BP target less than 120 mm Hg) was superior to standard BP control (SBP  less than 140 mmHg), reducing participants’ risk of cardiovascular events (ie., heart attack, stroke, heart failure) by 25 percent and mortality by 27 percent.

SRPINT enrolled middle-aged and older adults at high cardiovascular risk, but without diabetes and with baseline standard blood pressure readings of 130 to 180 mm Hg. The study was stopped early for benefit after median follow-up of 3 years (up to 6 years) limiting the ability to assess more long-term effects of the intensive vs standard blood pressure control strategies on life expectancy.

For the current analysis, study authors calculated the actuarial estimates of residual survival (at a given age) by using baseline age rather than time from randomization as the time axis. Residual life span at all ages (up to 95 years) was estimated using area under the survival curve. Differences in areas under the survival curves reflect estimated treatment effects on residual survival.

Mean survival benefits with intensive vs standard BP ranged from 0.5 years to 3 years (see Figure [click to enlarge]). Absolute survival gains decreased with age, but the relative benefits were relatively consistent (4-9 percent).

Results of the analysis demonstrate clear clinical benefits of more aggressive BP control. The findings also create a patient counseling opportunity as well, as summed up in an AHA press release by Mitchell SV Elkind, M.D., AHA  president-elect, chair of the advisory committee of the American Stroke Association, and professor of neurology and epidemiology at Columbia University.

"When you tell people that lowering their blood pressure is going to reduce their chance of having a stroke or a heart attack by 25%...what does that number mean, in real terms? This analysis suggests that for a man who is 50-years-old, lowering blood pressure to [<120 mm Hg]…could extend your lifespan by 3 years, on average."