Treat 'normal' blood pressure to save lives, study urges

Heart Attack
Myocardial Infarction or Heart Attack. Credit: Blausen Medical Communications/Wikipedia/CC-A 3.0

Millions of lives could be saved by giving blood pressure-lowering drugs to people at risk of heart attack and stroke, even if they have normal pressure, researchers said Thursday.

Based on an analysis of 123 medical trials involving more than 600,000 people over two decades, the team called for an urgent review of existing treatment guidelines.

"Our findings clearly show that treating blood pressure to a lower level than currently recommended could greatly reduce the incidence of cardiovascular disease," said study lead author Kazem Rahimi of the University of Oxford.

This could "potentially save millions of lives."

Blood pressure is recorded as two numbers, written as a ratio, for example 140/90 mmHg (millimetres of mercury—the blood pressure unit).

The number on top is the "systolic" pressure inside the arteries when the beats, and the other the "diastolic" pressure between beats, when the heart is at rest and refilling with blood.

According to the American Heart Association, a "normal" pressure is less than 120/80, and becomes high from 140/90.

The study found that every 10 mmHg reduction in systolic blood pressure reduced the risk of by about a fifth, of stroke and heart failure by about a quarter, and the risk of death from any cause by 13 percent.

"Importantly, these reductions in disease were similar across a wide range of patients... irrespective of whether their blood pressure was already low (less than 130 mmHg) to begin with," they wrote.

People at high risk include those with a history of heart or artery disease, stroke, diabetes or heart failure.

The researchers urged a revision of blood pressure guidelines, including those of the European Society of Hypertension which recently relaxed its recommended treatment level for high-risk patients from 130 to 140mmHg of .

It's relative

"Our results provide strong support for lowering blood pressure to less than 130 mmHg," wrote the team.

High blood pressure is the leading cause of heart disease and stroke, said the study authors, affecting more than a billion people worldwide and killing about 9.4 million every year.

The benefits of lowering sustained high pressure are well established, but it has not been clear whether people with "normal" pressure levels would also benefit from treatment.

University of Sheffield cardiologist Tim Chico, who was not involved in the study, stressed that the benefits of treatment for a person with "normal" blood pressure would depend on the individual's other risk factors for heart disease and stroke.

"For example, if you are already at a low risk, reducing this by 20 percent isn't all that important, and probably isn't either cost-effective or desirable," he said via the Science Media Centre.

"However, if you are at high risk (such as if you already have cardiovascular disease, diabetes or smoke) then a 20 percent reduction in risk makes a big difference and saves a lot of lives."

Anna Dominiczak, editor of the American Heart Association's journal Hypertension, said she would call for a debate on guidelines based on the study findings.


Explore further

Lower systolic blood pressure reduces risk of hypertension complication

Journal information: Hypertension

© 2015 AFP

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User comments

Dec 24, 2015
I smell a rat with this.

The renormalisation of medical metrics has been going on since drug companies began trying to increase sales of medications.

Its happened for cholesterol drugs, antidepressants and now blood pressure.

What is normal anyway.

It seems we are less normal than we used to be - including the medical profession.


Dec 24, 2015
Watch yourself marko. You wouldn't want to be diagnosed with lead poisoning. lol

Dec 24, 2015
Sounds like a money grab to me. So they want me to become dependent on a drug for my life when I have no issues. Rather than eating correctly and exercising. Once you start these medications you cannot just stop them without running a very high risk of stroke and heart attack. This group needs to disclose who paid for these studies. Other wise it gets filed in the snake oil that will kill you folder.

Dec 24, 2015
"For example, if you are already at a low risk, reducing this by 20 percent isn't all that important, and probably isn't either cost-effective or desirable," he said via the Science Media Centre.
"However, if you are at high risk (such as if you already have cardiovascular disease, diabetes or smoke) then a 20 percent reduction in risk makes a big difference and saves a lot of lives."

Seems the commenters didn't finish reading the article.

Dec 25, 2015
@You 3 knee jerk reactionaries: marko, PoppaJ & DavidW
Although article could have been written more 'in yer face' addressing underlying issue & stated it explicitly regarding "risk assessment" for those of short attention span, Vietvet is right on the money & even quoted the sentences relevant, sad 'You 3' couldn't see it !

DavidW claimed of Vietvet
They read it fine. You don't understand...
is soundly contradicted by DavidW's very own post "..educate them as how to avoid the risk in the first place" directly confirms underlying risk assessment issue but, squarely missed by DavidW's claim "..don't understand" - doh !

Irony of DavidW's position is he believes in an (abrahamic?) god but, itdidn't follow DavidW's advice to "..educate them as how to avoid the risk..", which is f..king obvious way of illustrating a claimed (any) just god doesn't exist, is only the idea of (Freudian!) men who seek a father figure.

How does any god communicate caringly DavidW ?


Dec 25, 2015
Of course "eating healthy" is made virtually impossible with our mass produced nutrient vacant food.

Sure nitrogen and phosphorus can make HUGE vegetables and fruits, but how good are they for you?

How much iron is in a potato where the iron has been stripped out by repeated monocrops?

Sure that tomato can be harvested when it's still green and will last 2 weeks in transit to the store, but how nutritious is an unripe tomato? Not very.

Same thing with the meat. How healthy would you be if you ate nothing but corn? Well how healthy do you think that cow you're eating was. If they didn't have a balanced diet then they're not part of yours.

Fix the food supply then concern yourself with health

Dec 25, 2015
Maybe you want to see and read this.

Australian ABC TV Catalyst Program :

Could our relentless pursuit of good health be making us sick? Advances in medicine have propelled health care to new heights and a vast array of diagnostic tests and drug therapies is now available. But are we getting too much of a good thing?

http://www.abc.ne...9690.htm

part 1

Dr Maryanne Demasi
One of the major contributors to the overuse of treatments is a phenomenon called diagnosis creep. It's when the threshold for treating a disease is lowered, so more and more people become eligible for that treatment simply because of a change in the way they define the disease. Then healthy people become classified as patients, and often end up on pills for the rest of their lives. Take the definition of high blood pressure, for example.

See next:

Dec 25, 2015
part 2

Dr Iona Heath
When I was a medical student, we used to define a normal blood pressure as being under 100 plus the person's age for the top number and 100 for the bottom number. Nowadays, it's 150/90, or if you're diabetic or you're worried about prehypertension, it's even as low as 140/80. By changing that threshold, you include millions more people in the range of abnormality and in the market for antihypertensive medication.

NARRATION
This has raised questions about whether people with mild hypertension would benefit from blood-pressure medication. While people with diabetes benefit, a Cochrane Review showed that most people with mild hypertension don't.

Dr Iona Heath
The treatment of mild hypertension has had no benefit on either morbidity or mortality, and that is the vast majority of people worldwide on treatment for hypertension.

So there.

Dec 26, 2015
Lord_jag offered
... "eating healthy" is made virtually impossible with our mass produced nutrient vacant food
Indeed, true for most part but, mass produced doesn't *have_to* mean nutrient deficient, there's traditional issues re horticulture ie fruits/veges/cereals often deficient in array of minerals & some plant's genome adapted to low nutrient soils, thus even adding fortification isn't helpful to absorbance, in some cases even kills plants - in comparison with varieties in Africa/South America which have adapted to high mineral soils from volcano ash washed down into alluvial plains

How do I know details ?
In 2010 completed post grad certification in Food Science at Curtin University - Western Australia (WA), found (peer reviewed) huge combinatorial issues notably key relationships between zinc, copper (Cu), iron (Fe), magnesium, iodine/selenium as key problematic nutrients in most WA soils

Eg Humans can't absorb Fe 'properly' except via Cu enzymes !

cont

Dec 26, 2015
Before drugs change what you eat and drink !!
Less salt, less sugar, less junk food , more exercices, is more useful and less dangerous than drugs !!

Dec 26, 2015
I am 87 years of age and take a 10mg Amlodipine each day which hauls my blood pressure down to 140, it also gives me swollen legs and sore feet and makes me lethargic.
If I cut down the dosage my pressure goes up to 190 but I feel much fitter and energetic it is only the thought of my father (a smoker) dying at 67 of a stroke keeps me taking the dammed things.
Maybe there is better medication but Amlodipine is what our NHS dishes out.

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