Lowering blood pressure is even more beneficial than previously thought

Blood pressure-lowering medication can prevent serious cardiovascular conditions such as strokes, heart failure and heart attacks in adults with normal blood pressure, according to research we part-funded and that was published in The Lancet.

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

Researchers at the University of Oxford studied 344,716 adults from 48 randomised trials to explore the effects of blood pressure-lowering medications. Participants were separated into two groups based on whether they had a prior diagnosis of cardiovascular disease or not, and then divided again into seven subgroups based on their systolic blood pressure when they started the study.

Participants were followed-up for an average of four years. During that period, 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 per cent. Stroke and heart failure risk dropped by 13 per cent, coronary heart disease by 8 per cent and death from cardiovascular disease by 5 per cent.

Fewer heart attacks and strokes

Professor Sir Nilesh Samani, our Medical Director, said:

“This study again emphasises the importance of controlling blood pressure as well as possible, to reduce the risk of heart and circulatory diseases.

“The benefits of lowering blood pressure are there whether you have pre-existing heart disease or not, and this study shows that lowering blood pressure - even if it is in the normal range - is associated with fewer heart attacks and strokes.

“This doesn’t mean we should treat everyone with blood pressure lowering drugs. If someone already has a low risk of heart disease, a 10 per cent reduction in their blood pressure may only carry a small direct benefit.

“Ultimately, the decision to treat blood pressure and the target level to aim for is something that requires a conversation between the patient and the doctor. It's also important to remember that blood pressure can be improved by means other than medication such as exercise and losing weight.”

The study was also funded by the National Institute for Health Research and Oxford Martin School, and was conducted by researchers from the Blood Pressure Lowering Treatment Triallists’ Collaboration.

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