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Review: Meds to Lower BP May Cut Risk for Major CV Events

FRIDAY, April 30, 2021 -- Pharmacologic therapy to reduce systolic blood pressure is associated with a lower risk for major cardiovascular events, regardless of previous diagnosis of cardiovascular disease and even at normal blood pressure, according to research published in the May 1 issue of The Lancet.

Kazem Rahimi, D.M., from the University of Oxford in the United Kingdom, and colleagues conducted a meta-analysis of individual participant-level data from 48 randomized trials (344,716 participants) of pharmacological blood pressure-lowering medications. Data were pooled to examine the stratified effects of blood pressure-lowering treatment in those with and without prevalent cardiovascular disease.

Baseline systolic blood pressure was less than 130 mm Hg for 19.8 and 8.0 percent of participants with and without previous cardiovascular disease, respectively. The researchers found that 12.3 percent of participants had at least one major cardiovascular event after a median 4.15 years of follow-up. The incidence rate for developing a major cardiovascular event per 1,000 person years was 31.9 in the comparator group and 25.9 in the intervention group among participants without previous cardiovascular disease at baseline. The corresponding rates were 39.7 and 36.0 in the comparator and intervention groups, respectively, among those with previous cardiovascular disease at baseline. A 5-mm Hg reduction in systolic blood pressure was associated with hazard ratios of 0.91 and 0.89 for a major cardiovascular event among those without and with previous cardiovascular disease, respectively.

"For people at risk of cardiovascular disease, pharmacological blood pressure-lowering treatment should become a cornerstone of risk prevention irrespective of cardiovascular disease status or blood pressure," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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