Pharmacologic antihypertensive treatment can significantly reduce the risk of cardiovascular events in patients after blood pressure exceeds certain thresholds, but it does not restore cardiovascular disease (CVD) risk to ideal levels, according to new research in the Journal of the American Heart Association.
The Multi-Ethnic Study of Atherosclerosis (MESA) was a multi-center longitudinal study of 5,798 patients aged 50–84 free of CVD at baseline over a mean follow-up of 9.5 years. Every 9–12 months, participants were contacted regarding interim hospital admissions, cardiovascular outpatient diagnoses, and procedures. Cardiovascular events included nonfatal myocardial infarction or stroke; hospitalization for angina pectoris, congestive heart failure (CHF), or transient ischemic attack; revascularization for or angiographically or ultrasound-demonstrated obstruction of carotid artery disease or peripheral arterial disease; fatal atherosclerotic coronary heart disease, fatal stroke, fatal atherosclerotic disease other than coronary or stroke, and fatal nonatherosclerotic cardiac disease.
The participants taking antihypertensive medication with well-controlled hypertension (<120/<80mmHg), had twice the risk of CVD events over the study period compared to participants with similar blood pressure levels without treatment. The findings from a larger study also indicate that middle-aged adults with blood pressure well-controlled by medication had longer exposure to higher blood pressure levels throughout young adulthood than those with ideal blood pressure without medication, leading to a significantly higher risk of end-organ damage and the presence of coronary artery calcification.
Additional research is needed to assess if earlier pharmacologic treatment could reduce this additional CVD risk, the authors concluded.
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