Antihypertensive medications can benefit all adults at an increased risk of cardiovascular disease (CVD) or stroke—not just those who have high blood pressure.
That was the conclusion of a new meta-analysis published in the Lancet. The study’s authors reached their conclusion by exploring data from nearly 345,000 patients who participated in one of 48 different randomized controlled trials. The average patient age was 65, and they were separated into subgroups based on their initial systolic blood pressure and their history of CVD.
After tracking four years of follow-up data, the team found that more than 42,000 patients had at least one major cardiovascular event. Such events included heart failure, CVD mortality, an acute myocardial infarction or a stroke.
For every 5 mm Hg reduction in a patient’s systolic blood pressure, their risk of developing major CVD decreased by approximately 10%. Similar decreases were seen in the risk of stroke (13%), heart failure (13%), ischemic heart disease (8%) and CVD mortality (5%).
In addition, the authors added, outcomes did not change significantly if a patient had a prior history of CVD.
These findings, the authors wrote, suggest that antihypertensive medications can offer substantial value to an even larger pool of patients than clinicians originally realized. Guidelines may need to be updated to reflect this fresh perspective.
“Our findings are of great importance to the debate concerning blood pressure treatment,” lead author Kazem Rahimi, DM, MSc, a professor of cardiovascular medicine and population health at the University of Oxford in the U.K., said in a prepared statement. “This new and best available evidence tells us that decisions to prescribe blood pressure medication should not be based simply on a prior diagnosis of cardiovascular disease or an individual’s blood pressure level. Instead, medication should be viewed as an effective tool for preventing cardiovascular disease in people at increased risk of developing heart disease or stroke. Clinical guidelines should be changed to reflect these findings.”
“It is important that people are considered for blood pressure-lowering treatment based on their cardiovascular risk, rather than focusing on blood pressure itself as a qualifying factor for or target of treatment,” added co-author Zeinab Bidel, also from the University of Oxford. “We must provide well-rounded guidelines to lower risks for cardiovascular disease that include exercise, nutrition, smoking cessation, and—where appropriate—medication.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.