High blood pressure, often called the “silent killer,” affects more than a billion people worldwide and leads to about 10 million deaths each year.
It rarely causes symptoms on its own, but it greatly increases the risk of heart attack, stroke, and kidney disease.
Despite many available medicines, fewer than one in five people with high blood pressure have it under control.
A new tool may finally help change that.
Scientists have created the first Blood Pressure Treatment Efficacy Calculator, based on data from nearly 500 clinical trials and more than 100,000 patients.
Published in The Lancet, this calculator can show doctors exactly how much different medications are likely to lower blood pressure. This could help them pick the best treatment plan for each patient, instead of relying on trial and error.
Dr. Nelson Wang, a cardiologist and research fellow at The George Institute for Global Health, explained why this matters: “Every single drop in blood pressure counts. Just a 1 mmHg decrease in systolic pressure lowers the risk of heart attack or stroke by about 2%.”
The problem is that with dozens of drugs, different doses, and the fact that most patients need more than one medication, there are thousands of possible combinations. Until now, there has been no simple way to compare their effectiveness.
The new calculator organizes treatments into three categories—low, moderate, and high intensity—similar to the system already used for cholesterol medicines.
On average, one blood pressure drug lowers systolic pressure by about 8 to 9 mmHg. But many people need reductions of 15 to 30 mmHg to reach safe levels. The calculator can help doctors choose the right combination to get there faster.
Traditionally, doctors have relied on repeated blood pressure readings to adjust medication, but this approach has limits. Blood pressure naturally changes from moment to moment, from day to day, and even by season.
These fluctuations can be as big—or bigger—than the changes caused by medicine. On top of that, measurements are often not done perfectly, making it hard to know if a treatment is truly working.
Professor Anthony Rodgers, also from The George Institute, said the calculator challenges the old “start low, go slow, measure and judge” approach. Instead, it allows doctors to begin with a clear target—how much pressure needs to drop—and then choose a treatment plan proven to achieve that.
The next step is to test the calculator in real-world clinics. If successful, it could mean faster, more precise care for millions of people. Even small improvements in blood pressure control on a global scale could save countless lives.
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