Blood Pressure Drugs May Help Heart Patients Without
TUESDAY, March 1 (HealthDay News) -- In people with heart
disease, the use of blood pressure-lowering medications can be
beneficial, even in those who don't have high blood pressure, new
The study found that when people without high blood pressure
were given blood pressure drugs, their risk of congestive heart
failure, stroke, all-cause mortality and a combination of
cardiovascular disease outcomes were reduced.
"If someone has had a previous heart attack or other cardiovascular event, and their blood pressure is in the normal range, they're still at risk of future cardiovascular events. There may be an additional benefit to giving an anti-hypertensive medication to these folks," said study author Angela M. Thompson, a doctoral research fellow in the department of epidemiology at Tulane University School of Public Health and Tropical Medicine in New Orleans.
"Current treatment recommendations advise treatment when the blood pressure is over 140/90 mm/Hg, but our study shows that you can obtain benefits even when the blood pressure is below that," Thompson explained.
In fact, the risk for cardiovascular disease begins at 115 mm/Hg
of systolic pressure (the top number on a blood pressure reading),
according to background information in the study.
In addition, in adults 55 years and older, the lifetime risk of
developing hypertension is more than 90 percent, the study
The study, which was funded by Tulane University and the
National Institutes of Health, was published in the March 2 issue
Journal of the American Medical Association.
Cardiovascular disease is the leading cause of death in the
United States, according to background information in the study.
About 54 percent of strokes and 46 percent of heart disease cases
occur in people who have blood pressure levels in the normal range,
the study reported.
The current study is a meta-analysis of 25 reports that were
selected from a pool of 874 studies. The selected studies included
almost 65,000 people without high blood pressure, and
three-quarters of the study participants were men. All had a
history of heart attack or other cardiovascular disease.
Most of the study volunteers were taking blood pressure
medications known as beta blockers or angiotensin-converting enzyme
(ACE) inhibitors, two commonly used classes of drugs for lowering
The researchers found that people taking blood pressure
medications had a 23 percent reduced risk of stroke, a 29 percent
reduced risk of congestive heart failure and a 15 percent reduction
in the risk of a combination of cardiovascular events. In addition,
the risk of cardiovascular mortality was reduced by 17 percent, and
the risk of all-cause mortality dropped by 13 percent in those
taking these medications compared to those who weren't on the
Thompson said the researchers don't know exactly how blood
pressure medications lowered the risk of cardiovascular events,
because this wasn't a study designed to look at the mechanism
behind the effect.
He and the other researchers reported no conflicts of
Dr. Mario Garcia, chief of cardiology at Montefiore Medical
Center in New York City, said the findings were "not surprising or
unexpected. These drugs all have beneficial effects beyond lowering
blood pressure. These drugs have already been shown to prevent
events in patients with heart attacks or heart failure."
Dr. Hector Ventura, director of cardiomyopathy and heart
transplantation at the Ochsner Health System in New Orleans, said,
"This study is kind of novel because they looked at people treated
with blood pressure medications without hypertension. And, even in
people without so-called hypertension, there might be a benefit
from these medications," he said.
But, he said, there are still a lot of unanswered questions. In
some cases, these medications could make blood pressure too low.
And, people would likely need to be on these medications
indefinitely, possibly for years. So, costs and potential side
effects have to be considered, said Ventura, who wrote an
accompanying editorial in the same issue of the journal.
In the editorial, Ventura concluded that the meta-analysis
"demonstrates that treatment of blood pressures lower than 140/90
mm/Hg is associated with benefits for patients with [cardiovascular
disease], but more clinical trial data are needed for those without
Learn more about blood pressure medications from the
American Heart Association.
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