N.C. – May 22, 2017 – A new study by researchers at Wake Forest
Baptist Medical Center has shown that aggressive lowering of blood pressure in
people with hypertension reduced the risk of left ventricular hypertrophy (LVH).
This condition, the enlargement and thickening of the walls of the heart’s main
pumping chamber, is the most common complication of high blood pressure and greatly
increases the risk of developing cardiovascular disease.
The study is published in the early online edition of the
“We know that high blood pressure could lead to LVH and
we know that lowering this pressure to the recommended levels improves it, but we
didn’t know if intensive lowering of blood pressure beyond recommended would
lead to more improvement in heart muscle,” said Elsayed z. Soliman, M.D., lead
author of the study and director of the epidemiological cardiology research
center at Wake Forest School of Medicine, a part of Wake Forest Baptist.
The objective of the study was to determine if lowering blood
pressure below what is generally recommended would lead to more benefits to the
heart muscle in terms of thickening (hypertrophy). And if so, would it
also prevent other cardiovascular events.
The research team examined these questions through
analysis of 8,164 participants from the National Institutes of Health’s Systolic
Blood Pressure Intervention (SPRINT) trial, which included patients with
hypertension but not diabetes. Participants were randomized to the intensive
blood pressure lowering group or the standard treatment group.
Study findings showed that lowering systolic blood
pressure to less than120 mmHg compared to the standard recommendation of 140
mmHg prevented development of new LVH in those without it and caused regression
of LVH in those who already had it.
“We thought that reducing heart muscle thickening would
correlate with fewer heart incidents associated with intensive lowering of high
blood pressure, but surprisingly that was not the case,” Soliman said.
“However, this favorable impact on heart muscle did not
explain most of the reduction in cardiovascular events associated with
intensive blood pressure lowering. More research is needed to understand what
factors determine which patients get the most benefits and less of the harm.”
These findings provide further evidence of the benefits
of the intensive blood pressure lowering in patients with hypertension, and
suggest that these benefits go beyond reducing the pressure and stress on the
Support for the study was provided by the National
Institutes of Health (SPRINT) and the Department of Veterans Affairs.
Co-authors include: Walter T. Ambrosius, Ph.D., and
Zhu-ming Zhang, M.D., of Wake Forest Baptist; William C. Cushman, M.D.,
Veterans Affairs Medical Center in Memphis; Jeffrey T. Bates, M.D., Michael E.
DeBakey VAMC and Baylor College of Medicine; Javier A. Neyra, M.D., University
of Kentucky; Thaddeus Y. Carson, M.D., Augusta University; Leonardo Tamariz,
M.D., University of Miami; Lama Ghazi, M.D., University of Minnesota; Monique
E. Cho, M.D., University of Utah; Brian P. Shapiro, M.D., Mayo Clinic,
Jacksonville, Fla.; Jiang He, M.D., Ph.D., Tulane University School of Public
Health and Tropical Medicine; Lawrence J. Fine, M.D., Dr.PH, National Heart,
Lung, and Blood Institute; Cora E. Lewis, M.D., University of Alabama at