Last updated on Jun 23rd, 2021 at 02:16 pm

Using intensive treatment to lower blood pressure to below currently recommended targets significantly reduces rates of major cardiovascular events like stroke and heart attack among a wide range of high-risk patients, according to a large meta-analysis involving almost 45 000 individuals, published in The Lancet.

Consistency of findings

“A key finding was the consistency of findings across major patient groups – those with cardiovascular disease, diabetes, renal disease and also those with just hypertension,” explains co-author Professor Jicheng Lv, from Peking University First Hospital, Beijing, China.

Treating high blood pressure is known to be closely associated with health in high-risk patients. But whether more intensive blood pressure lowering reduces the risk of major events like heart attack and stroke has been hotly debated. Research so far has produced conflicting results.

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Review and analysis of randomised trials

To address this uncertainty, the researchers did a systematic review and meta-analysis of all randomised trials comparing different blood pressure targets from 1950 up to the end of October 2015. In particular, they examined the potential benefits and safety of additional blood pressure lowering in high-risk individuals.

Blood-pressure lowering treatment was well tolerated, with serious adverse events occurring in similar numbers of individuals in both intensive and standard treatment groups. But, according to Professor Rodgers, “These adverse effects are important but do not outweigh the benefits of lowering blood pressure using intensive treatment in high-risk patients.”

More research needed

Professor Rodgers adds that much more research is needed to determine how best to easily and safely achieve and maintain greater blood pressure reductions. Improving treatment rates and long-term adherence is critical for the success of any intervention, whilst patients are also likely to benefit from non-drug approaches such as weight loss and restricting salt intake.”

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