Blood Pressure Therapies Lower CVD Risk, Regardless of Disease History


The largest and most comprehensive look at blood pressure therapies and cardiovascular disease risk to date is providing an overview of the effects of antihypertensive therapy at varying levels of baseline blood pressure.

New research from the Blood Pressure Lowering Treatment Trialists’ Collaboration (BPLTTC) is offering clinicians insight into the benefits of blood pressure-lowering therapy in patients with and without cardiovascular disease and with myriad of different blood pressure levels.

Results of the study, which included data from nearly 50 clinical trials encompassing at least 1000 person-years of follow-up data each, investigators found blood pressure-lowering therapies were associated with a decrease in risk of cardiovascular disease events regardless of whether a patient had hypertension or a history of cardiovascular disease.

“The decision to prescribe blood pressure medication should not be based simply on a prior diagnosis of cardiovascular disease or an individual’s current blood pressure. Rather, blood pressure medication should be viewed as an effective tool for reducing cardiovascular risk when an individual’s probability of having a heart attack or stroke is elevated,” said study presenter Kazem Rahimi, MD, Deputy Director of George Institute for Global Health, in a statement from the European Society of Cardiology (ESC).

Presented at the ESC Congress 2020, the latest study from the BPLTTC is billed by investigators as the largest and most detailed study ever conducted examining the impact of blood pressure-lowering therapy across groups with differing blood pressures and histories of cardiovascular disease. In total, the trial included data from 48 randomized clinical trials and 348,854 participants.

For the purpose of the analysis, investigators classified patients into 2 groups based on whether they had a history of cardiovascular disease. These patients were then divided into 7 subgroups based on systolic blood pressure at study entry—these groups were defined as less 120, 120-129, 130-139, 140-149, 150-159, 160-169, and 170 mmHg or greater.

Upon analysis, which included a mean of 4 years of follow-up per patient, investigators found every 5 mmHg reduction in systolic blood pressure was associated with a 10% reduction in relative risk of major cardiovascular events by about 10%. Results also indicated each 5 mmHg reduction was associated with decreases of 13%, 7%, 14%, and 5% in the risk for stroke, ischemic heart disease, heart failure, and death from cardiovascular disease, respectively.

For more on the latest study from the BPLTTC, Practical Cardiology reached out the Rahimi to take part in an interview further exploring the design and results of the study.

This study, “BPLTTC - Blood Pressure Lowering for Prevention of Cardiovascular Events across Different Levels of Blood Pressure,” was presented at ESC Congress 2020.

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