The Lancet has published new research showing that blood pressure-lowering medication can prevent serious cardiovascular conditions such as strokes, heart failure and heart attacks even in adults with normal blood pressure.
The study "Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis" was led by Prof Kazem Rahimi, Professor of Cardiovascular Medicine and Population Health, who leads the Deep Medicine programme at the Nuffield Department of Women’s and Reproductive Health.
It found the beneficial effects of treatment were similar regardless of the starting blood pressure level, in both people who had previously had a heart attack or stroke and in those who had never had heart disease. The findings have immediate and important implications for global clinical guidelines that typically limit blood pressure-lowering treatment to individuals with high blood pressure (usually above 140/90 mmHg).
Prof Kazem Rahimi commented:
“Our findings are of great importance to the debate concerning blood pressure treatment. 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.”
He cautions, “We’re not saying that everyone must begin treatment. The decision will depend on an individual’s risk factors for developing cardiovascular disease, the potential for side effects and patient choice.”
The study was funded by the British Heart Foundation, National Institute for Health Research, Oxford Martin School. It was conducted by researchers from the Blood Pressure Lowering Treatment Triallists’ Collaboration.