High Blood Pressure Research

• The Chronic Hypertension and Pregnancy   (CHAP) trial found that pregnant women who took medicines for mild chronic hypertension had fewer adverse pregnancy outcomes than the adults who did not. This included a lower chance of having a preterm birth or preeclampsia. In addition, the medicines did not impair fetal growth. The findings led to a practice advisory in 2022. See Treating chronic hypertension in early pregnancy benefits parents, babies to learn more.
  Research Funding

  Find funding opportunities and program contacts for high blood pressure research.

• The Dietary Approaches to Stop Hypertension (DASH) Sodium Trial showed that lowering sodium as part of a healthy eating plan significantly lowers blood pressure for people with high blood pressure. Researchers saw the greatest change when lowering sodium was combined with eating a diet rich in fruits and vegetables and low in saturated fat.
• The NHLBI’s Systolic Blood Pressure Intervention Trial (SPRINT) study found that treating to a lower systolic blood pressure target — less than 120 mm Hg — helped lower deaths from heart attack and stroke, particularly among older people who have high blood pressure. These findings informed the latest high blood pressure guidelines in 2017. A follow-up study called SPRINTMIND found that treating to this lower blood pressure target also reduced mild cognitive impairment, a condition that can lead to dementia.
• The NHLBI Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was the largest hypertension clinical trial ever conducted, involving more than 600 clinics and 42,000 participants. The study compared the effectiveness of three commonly used blood pressure-lowering medicines (a calcium channel blocker, amlodipine; an ACE-inhibitor, lisinopril; and an alpha-receptor blocker, doxazosin) with a diuretic, chlorthalidone. The trial concluded that the diuretic worked better than the other medicines to manage high blood pressure and prevent stroke, as well as some types of heart disease, especially heart failure.

Our Division of Cardiovascular Sciences and its Vascular Biology and Hypertension Branch oversee much of the research we fund on the regulation of blood pressure. 

Current research on the treatment of high blood pressure

NHLBI-supported research has led to creating and updating blood pressure treatments that have helped people around the world. High blood pressure affects millions of U.S. adults. We continue to support work on new treatments and also new approaches that tailor the right treatment to the right patient.

• Researchers in the NHLBI-funded Levy Lab are studying the role of genetics in cardiovascular disease using resources from the Framingham Heart Study to develop promising blood pressure medicines and treatments.
• The NHLBI funds research into the connection between inflammation and high blood pressure. Better understanding of the causes of hypertension helps researchers develop treatments to improve blood pressure management and prevent early death from cardiovascular disease.
• The NHLBI supports research to improve adherence to long-term cardiovascular medicines that help regulate blood pressure. Researchers use pharmacy data to identify patients who fail to refill their medicines. They then test whether reminders using text messages or interactive chat bots can improve medicine adherence.
• The NHLBI funds research into the connection between the microbiome and high blood pressure. One study found that bacterial strains in the mouth were linked to high blood pressure in older women. Another study showed that intermittent fasting in an animal model could reduce hypertension by reshaping the gut microbiota. 
• Findings from the Offspring Cohort of the Framingham Heart Study (FHS) and the Coronary Artery Risk Development in Young Adults (CARDIA) study showed a close association between hypertension and late-onset epilepsy and other brain changes, respectively, which may increase the risk of cognitive decline later in life.
• A clinical trial called Treating Resistant Hypertension Using Lifestyle Modification to Promote Health (TRIUMPH) showed that lifestyle modification, such as following the DASH eating plan, could significantly reduce blood pressure even in patients with resistant hypertension. Another study found that DASH was effective in adolescents with high blood pressure. 
• A clinical trial Chlorthalidone in Chronic Kidney Disease (CLICK) showed that the diuretic chlorthalidone can improve blood pressure control in patients with advanced chronic kidney disease. 
• A recent meta-analysis showed that use of anti-hypertension medicines that can cross the blood-brain barrier is linked to more cognitive benefits than those that do not cross the barrier. 

Find more NHLBI-funded studies on the high blood pressure treatment at NIH RePORTER.

NHLBI in the Press

Find out more about how the DASH diet and exercise help fight resistant high blood pressure.

Current research on women’s health and high blood pressure

NHLBI-supported research has helped reveal how pregnancy complications, including high blood pressure, affect the long-term health of women and their children.

• One study found that women who have a preterm birth have a greater chance of later developing high blood pressure.
• The NHLBI continues to fund the nuMoM2b Heart Health Study, which helps scientists understand how cardiovascular disease starts and develops in women. Researchers, funded by the NHLBI and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, found that women who developed complications during their first pregnancy were more likely to have had higher levels of blood sugar, blood pressure, and inflammation during their first trimester than women who did not develop complications. They are also more likely to develop chronic hypertension within 7 years after delivery. The study is also looking at the links between pregnancy, sleep health, and cardiovascular health.
• The NHLBI’s CHAP Maternal Follow-up Study is examining the impact of treatment for preeclampsia and high blood pressure during pregnancy on a woman’s future chance for developing cardiovascular disease. The results will help identify the best ways to improve the health of women younger than age 40 who have mild, long-term high blood pressure.

Find more NHLBI-funded studies on women’s health and high blood pressure at NIH RePORTER. 

Current research on health disparities and high blood pressure

Black adults in the United States have a higher prevalence of high blood pressure than other racial and ethnic groups. The NHLBI supports research to understand and reduce high blood pressure disparities, as part of our broader commitment to addressing health disparities and inequities.

Other studies and research areas we fund to understand and lower the impacts of health disparities are listed below:

• Our RURAL: Risk Underlying Rural Areas Longitudinal Cohort Study reaches 4,000 young and middle-aged men and women from different racial and ethnic groups living in poor rural counties in four southern states. The goal of the study is to understand what causes the high rates of heart and lung disease in these regions and how to lower those rates and improve prevention efforts.
• Co-funded by the NHLBI and the NIH Office of Research on Women’s Health, the Maternal Health Community Implementation Program (MH-CIP) supports community-engaged implementation research, working with affected communities to improve heart, lung, blood, and sleep health before, during, and after pregnancy. MH-CIP focuses on bringing effective maternal health interventions — including projects related to hypertension — into communities severely impacted by maternal health disparities.
• An NHLBI-funded study aims to improve implementation of the SPRINT findings in underserved populations. The study puts into practice a plan for blood pressure treatment at 30 clinics that serve people with little or no income in southeast Louisiana. The study’s findings will help lower barriers to blood pressure treatment faced by people who experience poverty.

Find more NHLBI-funded studies on high blood pressure and health disparities at NIH RePORTER. 

Research Feature

An NHLBI-funded project is studying how to better prevent and treat high blood pressure in Haiti.

The NHLBI Division of Intramural Research and its Cardiovascular Branch conduct research on diseases that affect the heart and blood vessels, including high blood pressure. Other Division of Intramural Research groups, such as the Center for Molecular Medicine and Systems Biology Center, perform research on heart and vascular diseases.

• In 2023, the NHLBI convened the Transforming Hypertension Diagnosis and Management in the Era of Artificial Intelligence (AI) workshop to discuss gaps and opportunities in leveraging AI technologies for hypertension diagnosis and management.
• The NHLBI’s Disparities Elimination through Coordinated Interventions to Prevent and Control Heart Disease Risk (DECIPHeR) program works with local communities to study proven interventions for hypertension. For one project, 51 adult primary care clinics use culturally tailored strategies to improve blood pressure management in Los Angeles, which has a particularly large and diverse population. Another DECIPHeR project is evaluating ways to integrate proven strategies into community clinics to reduce barriers to controlling high blood pressure for Black patients. The strategies include:
  • Nurse case management, in which a nurse provides behavioral counseling and monitors blood pressure through telehealth, adjusting blood pressure medications as needed 
  • Community health workers providing health coaching and information about community resources 

       Read more about the DECIPHeR program.

• In 2019, the NHLBI convened the HIV-associated Comorbidities, Co-infections & Complications Workshop, which led to strategies that support more research into the diseases, infections, and complications related to HIV. People with HIV have a higher risk of developing high blood pressure, even if they actively manage HIV infection with medicine.