Biohacking Kompakt

Podcast episode 114 (in German)

The blood pressure target – why the hundred and twenty means something different at home

October 22, 2026

A trial lowered mortality by 27 percent with a target of 120 — and a usual office measurement is on average 10.4 millimeters above that trial’s measurement. This episode explains why the 120 on a home device is not the same number as the one from the trial.

What it is about

The target of under 120 for the upper blood pressure value comes from a large, government-funded trial that tested it against a target of under 140 and was stopped early because of the clear benefit. The episode looks up how measurements were taken there: automated upper-arm device, 5 minutes of rest, 3 measurements, averaged, plus a cuff sized to arm circumference. That the participants were alone in the room is only half true — and plays the smaller role for the result. A second large trial from China confirmed the target even with observed measurement. The conclusion: the benefit of lowering blood pressure is very well supported, but a single reading from a home device cannot be held up against the 120 from the trial.

Key points

  • In the 2015 SPRINT trial with 9,361 people without diabetes, the target of under 120 lowered the primary endpoint with a hazard ratio of 0.75 and all-cause mortality with 0.73.
  • A Japanese study in 308 people with high blood pressure found the usual office measurement on average 10.4 millimeters higher for the upper value and 4.2 for the lower value than the measurement according to the study protocol, with a spread of 12.
  • In SPRINT, nobody was in the room at 38 centers with 4,082 participants, while at 25 centers someone stood by the whole time; the risk reduction was 0.62 and 0.64.
  • The 2024 Chinese trial with 11,255 participants from 116 clinics and communities measured under observation and, after an average of 3.4 years, came to 9.7 versus 11.1 percent, hazard ratio 0.88.
  • Anyone who would need the largest cuff and gets the normal one measures on average 19.5 millimeters too high — almost the entire gap of 20 between the two targets.
  • On average, the trial measurement was almost exactly on the morning reading at home, but for the individual it scattered by 17.8, and the correlation for the upper value was at most 0.16.
  • The stricter target brought more frequent low blood pressure, fainting, electrolyte disturbances and acute kidney failure, but not injurious falls; the trial was stopped after an average of 3.26 years.

Where the data stop

The target itself is well tested: 2 large trials, one partly without and partly with staff in the room, one observed throughout, both times with a benefit, the Chinese one also in 4,359 people with diabetes and 3,022 after a stroke. The limit lies in the transfer. Both trials measured according to protocol, with rest, repetition and a suitable cuff; a quick office measurement or a single morning reading comes about differently. The gap of 10.4 millimeters applies on average, not to you, and is not a conversion table. For a whole week of morning and evening readings there are separate thresholds, and your doctor interprets them.

The benefit has a price that belongs in medical hands, and nobody changes blood pressure medication because of a podcast episode. An analysis of 86,368 posts from social networks in 12 countries mainly shows that this number causes worry. It is a non-peer-reviewed preprint based on self-reports and says nothing about whether someone measures correctly.

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Published on October 22, 2026.

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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-22.