Blood pressure-lowering is even more beneficial than previously thought


Date:
September 1, 2020
Source:
European Society of Cardiology
Summary:
Blood pressure medication can prevent heart attacks and strokes -
even in people with normal blood pressure.



FULL STORY ========================================================================== Blood pressure medication can prevent heart attacks and strokes -- even
in people with normal blood pressure. That's the finding of late breaking research presented in a Hot Line session today at ESC Congress 2020.


========================================================================== "Greater drops in blood pressure with medication lead to greater
reductions in the risk of heart attacks and strokes," said principal investigator Professor Kazem Rahimi of the University of Oxford,
UK. "This holds true regardless of the starting blood pressure level,
in people who previously had a heart attack or stroke, and in people who
have never had heart disease." "The fact that the relative effects are
similar for everyone does not mean that everyone should be treated,"
he added. "This decision will depend on an individual's likelihood of
suffering cardiovascular disease in the future - - there are a number
of risk calculators health professionals can use. Other factors to
consider are the potential for side effects and the cost of treatment."
There has been controversy about whether pharmacological blood pressure lowering is equally beneficial in people with versus without a prior
heart attack or stroke, and when blood pressure is below the threshold
for hypertension (typically 140/90 mmHg). Evidence from previous studies
has been inconclusive, leading to contradictory treatment recommendations around the world.

This was the largest -- and most detailed -- study ever conducted to
examine these questions. The researchers combined data on individuals
who had participated in a randomised clinical trial and conducted a meta-analysis. The study included 348,854 participants from 48 trials.

Participants were divided into two groups: those with a prior diagnosis
of cardiovascular disease and those without. Each group was divided into
seven subgroups based on systolic blood pressure at study entry (less than
120, 120- 129, 130-139, 140-149, 150-159, 160-169, 170 and above mmHg).

Over an average four years of follow-up, each 5 mmHg reduction in systolic blood pressure lowered the relative risk of major cardiovascular events by about 10%. The risks for stroke, ischaemic heart disease, heart failure
and death from cardiovascular disease were reduced by 13%, 7% and 14%
and 5%, respectively.

Neither the presence of cardiovascular disease nor the level of blood
pressure at study entry modified the effect of treatment.

Professor Rahimi said: "The decision to prescribe blood pressure
medication should not be based simply on a prior diagnosis of
cardiovascular disease or an individual's current blood pressure. Rather,
blood pressure medication should be viewed as an effective tool for
reducing cardiovascular risk when an individual's probability of having
a heart attack or stroke is elevated."

========================================================================== Story Source: Materials provided by European_Society_of_Cardiology. Note: Content may be edited for style and length.


==========================================================================


Link to news story: https://www.sciencedaily.com/releases/2020/09/200901094058.htm

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