According to a latest study, more lives could be saved if doctors considered giving blood pressure drugs to all patients at high risk of heart disease despite their blood pressures being normal. The new study suggests doctors start treating their high risk patients for heart disease with blood pressure medications even if their pressures are in the normal range.
The new recommendation, BBC Health reports, is based on a review of 100 large-scale trials, embracing over 600,000 people. Those with particular ‘at risk’ lifestyle factors – smokers with high cholesterol levels and people over 65’s with diabetes – were found to potentially benefit the most from taking blood pressure lowering pills. The reason for this is based on people standing a better chance, should their health decline, from a lower blood pressure baseline.
The new research and recommendations are published in the medical journal The Lancet. The research paper is titled “Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis.”
Current protocols recommend starting medication when readings reach specific levels. The threshold used to be 130/85 mm Hg. But it was recently shifted to 140/90 mm Hg for non-elderly individuals, and 150/90 for the elderly. The newest and latest call for a new treatment regimen follows a review of 123 studies conducted between 1966 and 2015 that, in total, involved more than 600,000 people.
The new report was published in the Dec. 23 issue of The Lancet. “Our findings clearly show that treating blood pressure to a lower level than currently recommended could greatly reduce the incidence of cardiovascular disease and potentially save millions of lives if the treatment was widely implemented,” lead author Kazem Rahimi said in a journal news release. Rahimi is deputy director of The George Institute for Global Health at the University of Oxford in England.
“The results provide strong support for reducing systolic blood pressure to less than 130 mm Hg, and blood pressure-lowering drugs should be offered to all patients at high risk of having a heart attack or stroke, whatever their reason for being at risk,” Rahimi said.
The study found that every 10 mmHg reduction in systolic blood pressure reduced the risk of heart attack by about a fifth, of stroke and heart failure by about a quarter, and the risk of death from any cause by 13 per cent.
“Importantly, these reductions in disease were similar across a wide range of high risk patients… irrespective of whether their blood pressure was already low (less than 130 mmHg) to begin with,” they wrote.
University of Sheffield cardiologist Tim Chico, who was not involved in the study, stressed that the benefits of treatment for a person with “normal” blood pressure would depend on the individual’s other risk factors for heart disease and stroke.“For example, if you are already at a low risk, reducing this by 20 per cent isn’t all that important, and probably isn’t either cost-effective or desirable,” he said via the Science Media Centre. “However, if you are at high risk (such as if you already have cardiovascular disease, diabetes or smoke) then a 20 per cent reduction in risk makes a big difference and saves a lot of lives.”
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