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Blood pressure drugs rethink urged | |
(about 9 hours later) | |
More lives could be saved if doctors considered giving blood pressure drugs to all patients at high-risk of heart disease - even if their blood pressures are normal, a study suggests. | More lives could be saved if doctors considered giving blood pressure drugs to all patients at high-risk of heart disease - even if their blood pressures are normal, a study suggests. |
The report calls for a move away from current guidelines which recommend pills only be prescribed if blood pressure is above a certain threshold. | The report calls for a move away from current guidelines which recommend pills only be prescribed if blood pressure is above a certain threshold. |
But experts acknowledge lifestyle factors also have an important role to play in bringing blood pressures down. | But experts acknowledge lifestyle factors also have an important role to play in bringing blood pressures down. |
The study appears in the Lancet. | The study appears in the Lancet. |
High blood pressure has long been linked to a higher risk of heart disease and stroke. | High blood pressure has long been linked to a higher risk of heart disease and stroke. |
Current guidelines - issued by England's National Institute for Health and Care Excellence - suggest patients should only take medication when their blood pressure levels reach 140 mmHg. | Current guidelines - issued by England's National Institute for Health and Care Excellence - suggest patients should only take medication when their blood pressure levels reach 140 mmHg. |
Until this point even those at highest risk, for example people who have had previous heart attacks and strokes, are offered monitoring but not pills. | Until this point even those at highest risk, for example people who have had previous heart attacks and strokes, are offered monitoring but not pills. |
Now a global team of experts are calling for doctors to focus on an individual's risks rather than rigid and "arbitrary" blood pressure thresholds. | Now a global team of experts are calling for doctors to focus on an individual's risks rather than rigid and "arbitrary" blood pressure thresholds. |
Large trial | Large trial |
Experts analysed the results of more than 100 large-scale trials involving some 600,000 people between 1966 and 2015. | Experts analysed the results of more than 100 large-scale trials involving some 600,000 people between 1966 and 2015. |
They found those patients at highest risk - including smokers with high cholesterol levels and people over 65s with diabetes - would benefit most from treatment, lowering their chance of heart attacks and strokes. | They found those patients at highest risk - including smokers with high cholesterol levels and people over 65s with diabetes - would benefit most from treatment, lowering their chance of heart attacks and strokes. |
In addition the report suggests once on treatment, blood pressure levels could be reduced even further than the targets currently used. | In addition the report suggests once on treatment, blood pressure levels could be reduced even further than the targets currently used. |
The study also adds to growing evidence that patients may benefit from lowering their blood pressure whatever their baseline levels - either through lifestyle changes or drugs. | The study also adds to growing evidence that patients may benefit from lowering their blood pressure whatever their baseline levels - either through lifestyle changes or drugs. |
But it shows the lower the person's blood pressure to start with, the lower the benefit they gain from reducing it. | But it shows the lower the person's blood pressure to start with, the lower the benefit they gain from reducing it. |
The authors do not go as far as to suggest everyone should be given pills and caution side-effects of medication must be weighed up. | The authors do not go as far as to suggest everyone should be given pills and caution side-effects of medication must be weighed up. |
Prof Liam Smeeth, of the London School of Hygiene and Tropical Medicine, agreed the findings were important for those at highest risk. | Prof Liam Smeeth, of the London School of Hygiene and Tropical Medicine, agreed the findings were important for those at highest risk. |
But he warned: "One important caveat is that not everyone will be able to tolerate having their blood pressure reduced to low levels, and there is a need to balance possible drug side effects and likely benefits." | But he warned: "One important caveat is that not everyone will be able to tolerate having their blood pressure reduced to low levels, and there is a need to balance possible drug side effects and likely benefits." |
Heart specialist Dr Tim Chico, of the University of Sheffield, said medication need not be the only way to tackle the issue. | Heart specialist Dr Tim Chico, of the University of Sheffield, said medication need not be the only way to tackle the issue. |
He added: "We can all reduce our blood pressure. | He added: "We can all reduce our blood pressure. |
"We can do this safely, cheaply and as effectively as tablets by eating healthily, taking more physical activity, reducing alcohol intake, and maintaining a healthy weight." | "We can do this safely, cheaply and as effectively as tablets by eating healthily, taking more physical activity, reducing alcohol intake, and maintaining a healthy weight." |