Lower Blood Pressure Target May Reduce Heart Disease and Save Lives

Kazem Rahimi | FRCP DM MSc FESC Associate Professor of Cardiovascular Medicine, University of Oxford Deputy Director, The George Institute for Global Health James Martin Fellow in Healthcare Innovation, Oxford Martin School Honorary Consultant Cardiologist, Oxford University Hospitals NHS Trust

Prof. Kazem Rahimi

MedicalResearch.com Interview with:
Kazem Rahimi | FRCP DM MSc FESC
Associate Professor of Cardiovascular Medicine, University of Oxford
Deputy Director, The George Institute for Global Health
James Martin Fellow in Healthcare Innovation, Oxford Martin School
Honorary Consultant Cardiologist, Oxford University Hospitals NHS Trust

Medical Research: What is the background for this study? What are the main findings?

Prof. Rahimi: Although the benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established, the extent to which these effects differ by baseline blood pressure, presence of co-morbidities (such as stroke or diabetes), or drug class is less clear.

Medical Research: What should clinicians and patients take away from your report?

Prof. Rahimi: Our study has several implications for clinical practice. Our findings suggest that blood pressure lowering to levels below those recommended in current guidelines (ie, systolic

blood pressure of less than 140 mm Hg) will reduce the risk of cardiovascular disease. By showing no evidence for a threshold below which blood pressure lowering ceases to work, the findings call for blood pressure lowering based on an individual’s potential net benefit from treatment rather than treatment of the risk factor to a specific target. Furthermore, the differences we identified between classes of drugs support more targeted drug use for individuals at high risk of specific outcomes (eg, calcium channel blocker therapy for individuals at high risk of stroke or and diuretics are more eff ective for prevention of heart failure).

Overall, our findings clearly show that treating blood pressure to a lower level than currently recommended could greatly reduce the incidence of cardiovascular disease and potentially save millions of lives if the treatment was widely implemented. The results provide strong support for reducing systolic blood pressure to less than 130 mmHg, and blood pressure-lowering drugs should be offered to all patients at high risk of having a heart attack or stroke, whatever their reason for being at risk. 

Medical Research: What recommendations do you have for future research as a result of this study?

Prof. Rahimi: A limitation of our meta-analysis was that we had no individual patient data, the use of which would have provided greater detail about the effects of blood pressure lowering at various levels of baseline systolic blood pressure, or individual patient co-morbidities. Future research could explore these questions further.

Citation:

Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysi

Kazem Rahimi | FRCP DM MSc FESC (2015). Lower Blood Pressure Target May Reduce Heart Disease and Save Lives 

Published Online: 23 December 2015

DOI: http://dx.doi.org/10.1016/S0140-6736(15)01225-8

Kazem Rahimi | FRCP DM MSc FESC (2015). Lower Blood Pressure Target May Reduce Heart Disease and Save Lives 

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