Blood pressure-lowering drugs for all?

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UK researchers suggest that blood pressure-lowering drugs can help prevent heart disease and stroke in any at-risk individuals, even if they do not have High Blood Pressure—and nearly everybody is at some degree of risk for these conditions as they get older.

Dr. Malcolm R. Law and colleagues came to that conclusion after pooling data on a large number of subjects who participated in previous clinical trials. “Our results,” they conclude, “indicate the importance of lowering blood pressure in everyone over a certain age, rather than measuring it in everyone and treating it in some.”

To investigate the use of blood pressure-lowering drugs in preventing cardiovascular disease, the investigators analyzed data from 147 clinical trials involving a total of 464,000 people, according to their report in the British Medical Journal.

The investigators found that for a given reduction in blood pressure, the various classes of antihypertensive agents had similar effects in preventing coronary heart disease events and stroke.

Furthermore, taking blood pressure-lowering drugs reduced the risk of cardiovascular “events” to a similar extent regardless of the initial blood pressure or the presence or absence of pre-existing cardiovascular disease, the analysis showed.

Based on the findings, Law, at Queen Mary University of London, and colleagues believe that guidelines on the use of blood pressure-lowering agents can be simplified so that individuals with all levels of blood pressure are offered these medications.

SOURCE: British Medical Journal, Online First May 20, 2009.

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