Blood pressure-lowering drugs for all?

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.