Antihypertensives benefit normotensive CVD patients
MedWire News: Cardiovascular disease (CVD) patients without clinically-defined hypertension may reduce their risk for cardiovascular events and all-cause mortality by taking antihypertensive medication, results from a US meta-analysis indicate.
Such patients include those with blood pressure (BP) levels in the normal (≤130/85 mmHg) and prehypertensive ranges (131-139 mmHg systolic, 86-89 mmHg diastolic BP), say the authors in JAMA.
"Although pharmacologic treatment for all individuals in this population would not be economically feasible, a more reasonable strategy might be to identify groups within the prehypertensive population who would obtain the greatest benefit from early pharmacologic treatment," suggest Lydia Bazzano (Tulane University, New Orleans, Louisiana) and team.
In an accompanying editorial, Hector Ventura (Ochsner Medical Center, New Orleans) and Carl Lavie (University of Queensland School of Medicine, Brisbane, Australia) wrote: "Because many patients could potentially begin taking medications at young ages and for many years to prevent CVD events, even modest costs and adverse effects [associated with antihypertensive treatment] need to be considered."
To assess the effect of antihypertensive treatment on normotensive and prehypertensive patients, Bazzano et al analyzed the findings from 25 studies with 64,162 nonhypertensive (BP<140/90 mmHg) CVD patients aged 55-68 years.
All patients were randomly assigned to receive antihypertensive medications (beta blockers, angiotensin receptor blocker, or ACE inhibitors combined with a diuretic or calcium channel blocker) or placebo for a period ranging from 1.5 to 63.0 months.
The researchers found that among the patients who took antihypertensives, the respective risks for stroke, myocardial infarction, and congestive heart failure were a significant 23%, 20%, and 29% lower than those of the placebo group.
Treated patients also had significantly lower risks for CVD-related mortality (17% lower) and all-cause mortality (13% lower) than those who took placebo.
These findings remained significant irrespective of the class of antihypertensive taken.
Bazzano and team conclude: "Additional randomized trial data are necessary to assess these outcomes in patients without CVD clinical recommendations."
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By Lauretta Ihonor