Benefits of Blood Pressure-Lowering Seen at All Levels of CV Risk — Physician’s First Watch
Benefits of Blood Pressure-Lowering Seen at All Levels of CV Risk
By Amy Orciari Herman
Blood pressure-lowering therapy helps prevent cardiovascular events at all levels of baseline risk, according to a Lancet meta-analysis.
The analysis included 11 trials that randomized over 50,000 patients to BP-lowering drugs or placebo, or to more- or less-intensive regimens. Participants were divided into four categories according to 5-year risk for major CV events (risk calculations included variables such as age, smoking status, and diabetes).
Over 4 years' follow-up, BP-lowering therapy (relative to control) conferred a similar relative reduction in major CV events in each risk category (roughly 15%). Accordingly, absolute risk reductions increased at higher levels of baseline risk. The authors calculated that treating 1000 patients for 5 years would prevent 14 CV events in the lowest-risk group and 38 in the highest-risk group.
Commentators say the findings "could affect future revisions of hypertension guidelines that seem to be reluctant to consider total cardiovascular risk, instead of blood pressure alone, as the main driving force to guide initiation of treatment."