SPRINT Study: You Don’t Need More Blood Pressure Drugs
I don’t see eye-to-eye with conventional medicine. I treat the whole person, from the inside out. I vastly favor gentle, natural remedies over powerful, lab-made prescription drugs that only treat symptoms.
So when last September’s superstar NIH blood pressure study wasn’t the game changer anticipated by the NIH research team, some docs might have been disappointed.
At first glance, a real breakthrough
There was such excitement—major health improvements for people with hypertension and other risks for stroke and heart disease!
Just get your patient’s systolic pressure—the first of the two measurement numbers—below the long-time target of 140, aiming at below 120, and great things happen!
Sure enough, getting systolic pressure below 120 reduced heart attacks, heart failure, and strokes by nearly 33 percent, and the risk of death by almost 25 percent.
Sounds great, no?
Right away, docs like me were skeptical.
First off, the research compared two groups for incidence of heart attacks, heart failure, and stroke. One group took the current, conventional two-drug treatment. The other took an additional drug.
Wait—three drugs is better than two?
How about no drugs is better than drugs? Period?
Consternation will raise anyone’s blood pressure. Mine goes up when I see mainstream medicine galloping to the “rescue” with handfulls of meds.
Another concern: the September results included no data on side effects, which are essential for assessing safety.
Sure enough, the new data give us more reasons to consider the 120 systolic target with care. In the three-drug group, there was a greater risk of side effects—some quite serious:
- Blood pressure dropped too much?
- 4 percent in the three-drug group vs. 2.0 percent for the conventional group
- Fainting, obviously with serious risk of falling?
- 5 percent vs. 2.4 percent
- Acute kidney injury or failure?
- 4 percent vs. 2.6 percent
Those are pretty consequential increases.
A non-representative sample
There’s yet another reason you should not automatically worry if your BP is over 120.
These results are potentially meaningful to only a fraction of the people already being treated for high blood pressure, and an even smaller group of others.
First: overall, about one in 12 Americans with high blood pressure would have been considered eligible for the study, or about 17 million adults. Of those already being treated for high blood pressure, only one in six would have been eligible for the study. To be included in the study, you had to be over 50, have systolic blood pressure (the top number) between 130 and 180, have risk factors such as heart disease, kidney disease, or being over 75, but not have diabetes or have already suffered a stroke.
Second: the study was designed to avoid white coat syndrome when measuring participants’ blood pressure. That means the effects were probably true effects on blood pressure, but also that they may have less in common with your blood pressure reading taken by a doctor.
We can’t assume these results would be the same across the board.
For the moment, at least, that makes these findings less relevant to them. Maybe further research will open better doors to more people. I hope so.
Who, if anyone, should consider this as a potential treatment option?
- If you’re 50 or older, with a top systolic number between 130 and 180
- If you’re 75 or older
- If you have a high risk of stroke or heart or kidney disease
If you’re being treated for blood pressure but would not have qualified for this study, including if you have diabetes, I can’t yet recommend you do anything different. As always, consult with your doctor.
And as always, there are many natural ways to prevent and reduce high blood pressure.
- No smoking, moderate alcohol, limited caffeinated or sugary drinks.
- Seven to eight hours sleep a night.
- Water. Half an ounce per pound of body weight per day. So: 140 pounds? 70 ounces of water—paced through the day. Easier than it sounds.
- Whole, fresh foods—lean meats and poultry, organic fruits and vegetables, unsalted nuts and seeds, legumes, whole grains, low-fat dairy (or alternatives e.g., almond or rice milk). Good fats like avocado and olive and sesame oils. Celery, garlic, raw cacao, cayenne pepper, and eggs.
- No high-sodium foods, fast food, sugar, processed snacks/meals, and trans fats.
- De-stress with therapy, meditation, yoga, tai chi, qigong, deep breathing, visualization, and exercise.
- Walk for 10–15 minutes a day, increasing your time and distance, or interval and weight training.
- Diao D, Wright JM, Cundiff DK, Gueyffier F. Pharmacotherapy for mild hypertension. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD006742. DOI: 10.1002/14651858.CD006742.pub2.
- Stone, K. (2015). “NIH SPRINT study sparks questions about overtreatment of mild hypertension.” http://www.healthnewsreview.org/2015/09/nih-sprint-study-sparks-questions-about-overtreatment-of-mild-hypertension/
- National Institutes of Health Department of Health and Human Services (2015). “Systolic Blood Pressure Intervention Trial (SPRINT) Questions and Answers.” http://www.nhlbi.nih.gov/news/spotlight/fact-sheet/systolic-blood-pressure-intervention-trial-sprint-questions-and-answers. Last Updated: September 11, 2015
- The SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015; 373:2103-2116 November 26, 2015DOI: 10.1056/NEJMoa1511939
- Hensley, S. Aggressive Lowering Of Blood Pressure Carries Risks As Well As Benefits. Updated November 10, 20155:34 PM ET. Published November 9, 20154:19 PM ET http://www.npr.org/sections/health-shots/2015/11/09/455344298/aggressive-lowering-of-blood-pressure-carries-risks-as-well-as-benefits
- Krumholz, Harlan M. 3 Things to Know About the Sprint Blood Pressure Trial.NOVEMBER 9, 2015 2:00 PM. http://well.blogs.nytimes.com/2015/11/09/3-things-to-know-about-the-sprint-blood-pressure-trial/