Lowering BP in already healthy individuals reduces CVD risk

A large meta-analysis by the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC), was presented at the virtual European Society of Cardiology (ESC) Congress 2020 on August 31 this year. The main findings highlighted that lowering blood pressure by a set amount reduces the risk of future cardiovascular events even for individuals who have normal blood pressure and no history of heart disease. The results looked at 48 studies around the globe, encompassing 348,854 participants. For the first time, enough participants that had “normal’ blood systolic pressures of 120-140mm Hg, were followed to gather this insight.

The SPIRIT study by the National Institutes of Health (NIH) released in 2015 initially found that a more intensive strategy of lowering blood pressure—one that aims to achieve a systolic blood-pressure target of 120 mm Hg—reduced the risk of death and cardiovascular events when compared with a strategy that lowers systolic blood pressure to conventional targets. However, this study was still limited by focusing on those who had initial systolic pressures over 140 and a history of heart disease.

The new meta-analysis and its results could enforce a change in the patient care recommendations. For instance, currently hypertensive medication (medication that lowers blood pressure) are only considered in patients whose systolic blood pressure is over 140mm Hg. However, this new information suggests it would be more prudent to prescribe these medications if someone has a high cardiovascular risk score down to a systolic blood pressure of 115mm hG. Cardiovascular risk can be determined using a calculator like the QRISK3 (https://qrisk.org/three/).

The phases in the collaboration were successful in providing reliable evidence for the benefits of blood pressure-lowering for the prevention of future major cardiovascular events. Lowering of blood pressure, even when pressure is within normal limits, reduces cardiac risk regardless of a history of cardiovascular disease.

To read more on this interesting topic, you can find the specific BPLTTC and SPRINT Trial Results in the following links:

• http://www.bplttc.org/#learnmore
• www.ahajournals.org › HYPERTENSIONAHA.115.06722