People with normal blood pressure could benefit from blood pressure drugs

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Scientists from the University of Oxford found that blood pressure-lowering medication can prevent serious cardiovascular conditions such as strokes, heart failure, and heart attacks even in adults with normal blood pressure.

They found the beneficial effects of treatment were similar regardless of the starting blood pressure level, in both people who had previously had a heart attack or stroke and in those who had never had heart disease.

The research is published in The Lancet and was conducted by Professor Kazem Rahimi et al.

Heart disease and stroke, linked to high blood pressure, are the leading cause of death across most of the western world.

It is widely accepted that blood pressure medication protects people who have had a prior heart attack or stroke from having a second, but the use of these drugs in people with normal or mildly elevated blood pressure has been debated.

In the study, the team used data from 344,716 adults (average age 65 years) in 48 clinical trials to explore the effects of blood pressure-lowering medications.

Participants were separated into two groups: those with a prior diagnosis of heart disease and those without.

Over an average of four years of follow-up, 42,324 participants had at least one major cardiovascular event (heart attack, stroke, heart failure, or death from cardiovascular disease).

For every 5-mmHg reduction in systolic blood pressure, the risk of developing major cardiovascular disease fell by around 10%, stroke by 13% (6,005 vs 7,767), heart failure by 13%, ischaemic heart disease by 8%, and death from cardiovascular disease by 5%.

The beneficial effects of the treatment did not differ based on a history of having had heart disease or the level of blood pressure at study entry.

The team says this new evidence tells us that decisions to prescribe blood pressure medication should not be based simply on a prior diagnosis of cardiovascular disease or an individual’s blood pressure level.

Instead, medication should be viewed as an effective tool for preventing cardiovascular disease in people at increased risk of developing heart disease or stroke. Clinical guidelines should be changed to reflect these findings.

If you care about blood pressure, please read studies about potatoes and high blood pressure: what you need to know, and the best way to measure blood pressure.

For more information about blood pressure, please see recent studies about how to live long with high blood pressure, and results showing vitamin B could help treat drug-resistant high blood pressure.

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