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August 13, 2014
Kidney Failure, Death Increases With Too High or Too Low Blood Pressure

Pasadena, CA—Lower isn’t always better for hypertension, according to a new study that finds too high or too low blood pressure both put patients at risk of kidney failure or death.

The Kaiser Permanente study was published recently in the Journal of the American College of Cardiology.

Reviewing electronic health records of nearly 400,000 Kaiser Permanente patients in Southern California who were taking medications to treat high blood pressure from January 2006 through December 2010, researchers found that patients within the range between 130 and 139 systolic and between 60 and 79 diastolic blood pressure were at the lowest risk for kidney failure and death.

Those with blood pressure outside of that range, either above or below, were more likely to have increased health risks.

In fact, patients who had a systolic blood pressure in the range between 120 and 129—which is generally accepted as normal—were 10% more likely than those who had a systolic blood pressure between 130 and 139 to die or develop kidney failure. Patients who had a systolic blood pressure between 140 and 149 were 40% more likely than those who had a systolic rate between 130 and 139 to die or develop kidney failure.

“Physicians have often emphasized the need to bring a patient's blood pressure down as low as possible for the best outcomes,” said lead study author John J. Sim, MD, of Kaiser Permanente Los Angeles Medical Center. “However, the findings of our study suggest that treating patients with high blood pressure too aggressively may potentially lead to poor health outcomes.”

Study authors also point to the need to better understand the ideal target blood pressure ranges as well as the potential dangers of over-treatment.

“We hope our findings will pave the way for a more effective strategy in treating high blood pressure,” Sim said. “Through personalized treatment plans, we can minimize the lifestyle burden on patients and improve the safety of their treatment regimens, while reducing the cost to both patients and the health care system as a whole.”

The study notes that, although current treatment guidelines recommend that adults between 30 and 59 years old with hypertension should target a blood pressure below 140 systolic and 90 diastolic, those guidelines do not mention the dangers of having a patient’s blood pressure drop below a certain level. Study authors are calling for additional research to lead to more accurate guidelines to protect patient health.



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