Treating Hypertension Beneficial Regardless of Baseline Pressure
HealthDay News — Blood pressure lowering treatment reduces the risk of major cardiovascular disease events, with reductions seen regardless of starting blood pressure, according to research published online Dec. 23 in The Lancet.
Dena Ettehad, from the George Institute for Global Health in Oxford, U.K., and colleagues conducted a systematic review and meta-analysis of large-scale blood pressure lowering trials. A total of 123 studies with 613,815 participants were included in the meta-analysis.
The researchers found that relative risk reductions were proportional to the magnitude of blood pressure reductions. The risks of major cardiovascular disease events, coronary heart disease, stroke, and heart failure were reduced for every 10mmHg reduction in systolic blood pressure (relative risks, 0.80, 0.83, 0.73, and 0.72, respectively), which correlated with a significant 13% reduction in mortality in the populations studied. No significant effect on renal failure was observed (relative risk, 0.95; 95% CI: 0.84–1.07). In trials with higher and lower mean baseline systolic blood pressure, similar proportional risk reductions were observed. There was no clear evidence for variation in proportional risk reduction in major cardiovascular disease based on baseline disease history, with the exception of diabetes and chronic kidney disease, which correlated with smaller risk reductions. Compared with other drugs, β-blockers were inferior for prevention of major cardiovascular disease events, stroke, and renal failure; calcium channel blockers were superior to other drugs for stroke prevention.
"Blood pressure lowering significantly reduces vascular risk across various baseline blood pressure levels and comorbidities," the authors write. "Our results provide strong support for lowering blood pressure to systolic blood pressures less than 130mmHg."
Two authors disclosed financial ties to Servier.