High Blood Pressure
Meds Protect Cardiovascular Patients from Stroke, Death
Many studies show
persons with CVD can obtain significant
benefit from antihypertensive treatments
1, 2011 - Seniors citizens
battling cardiovascular disease may want to consider a prescription for
high blood pressure medications, even if their blood pressure is fine.
These hypertension drugs appear to reduce the risk of stroke, congestive
heart failure and death from all causes according to an analysis of more
than two dozen studies that appears in tomorrow's issue of
the Journal of the American
Medical Association (JAMA).
Cardiovascular disease (CVD) is the leading cause of death globally,
representing 30 percent of all deaths worldwide. In adults 55 years and
older, lifetime risk of developing hypertension is greater than 90
● High blood pressure
● Coronary heart disease
Angina pectoris (chest pain or discomfort caused by reduced
blood supply to the heart muscle)
● Heart Failure
"Cardiovascular disease risk increases beginning at systolic blood
pressure levels of 115 mm Hg. Use of antihypertensive medications among
patients with a history of CVD or diabetes and without hypertension has
been debated," according to background information in the article.
Angela M. Thompson, M.S.P.H., of the Tulane University School of Public
Health and Tropical Medicine, New Orleans, and colleagues conducted a
meta-analysis to evaluate the association between anti-hypertensive
treatment and secondary prevention of CVD events and all-cause death
among persons without clinically defined hypertension (140 mm Hg
systolic or greater or 90 mm Hg diastolic or greater and/or use of
antihypertensive medications or history of hypertension).
From 874 potentially relevant publications, the researchers identified
25 trials that fulfilled the predetermined inclusion and exclusion
criteria for the meta-analysis. These 25 studies incorporated data from
64,162 participants without hypertension, of whom 76 percent were men.
For the various outcomes, the researchers found the following:
● a 23% reduction in risk of stroke;
● a 29% reduction in risk of congestive heart failure (CHF) events;
● a 15% reduction in risk of composite (combination of disease
outcomes) CVD events; and
● a 13% reduction in risk for all-cause mortality.
"Our results show that persons with a history of CVD but with blood
pressures in the normal and prehypertensive ranges can obtain
significant benefit from antihypertensive treatments," the authors
affects nearly 30 percent of the adult population and carries an
elevated risk for CVD incidence and mortality. To our knowledge, this
meta-analysis is the first to examine the association between
antihypertensive medications and CVD morbidity and mortality as well as
all-cause mortality in individuals without hypertension.
Among patients with clinical history of CVD but without hypertension,
antihypertensive treatment was associated with decreased risk of stroke,
CHF, composite CVD events, and all-cause mortality. Additional
randomized trial data are necessary to assess these outcomes in patients
without CVD clinical recommendations."
Antihypertensive Therapy for Prehypertension
Because many patients with prehypertension could potentially begin
taking medications at young ages and for many years to prevent
cardiovascular events, even modest costs and adverse effects need to be
considered, according to an editorial in the same JAMA issue by Hector
O. Ventura, M.D., and Carl J. Lavie, M.D., of the John Ochsner Heart and
Vascular Institute, New Orleans, and University of Queensland School of
Medicine, Brisbane, Australia.
"Lifestyle modifications that have been shown to reduce blood pressure
and decrease cardiovascular morbidity and mortality should be
recommended for all patients with blood pressure levels less than 140/90
mm Hg, they write.
However, to reach firmer conclusions will require more data from
randomized trials involving patients with levels less than 140/90 mm Hg
to evaluate the effects of various pharmacological therapies on
preventing CVD outcomes."
High Blood Pressure Medications
By American Heart Association
Treating high blood pressure requires patience and
care by both doctor and patient. It may be annoying to take pills and
possibly have side effects, especially if you felt fine before
treatment. Don't be discouraged if you must be treated indefinitely.
Some people can reduce their drug dosages after achieving normal blood
pressure and maintaining it for a year or more. (You usually can't stop
treatment entirely.) Coping with the inconvenience of medication is
still much better than suffering a stroke or heart attack. An
appropriate diet and regular physical activity are important as part of
the treatment, and for people with mild high blood pressure these could
be enough to control blood pressure without medication.
*Some of the major types of commonly prescribed
cardiovascular medications are summarized in this section. For your
information and reference, we have included generic names as well as
major trade names to help you identify what you may be taking; however,
the AHA is not recommending or endorsing any specific products. If your
prescription medication isn't on this list, remember that your
healthcare provider and pharmacist are your best sources of
information. It's important to discuss all of the drugs you take with
your doctor and understand their desired effects and possible side
effects. Never stop taking a medication and never change your dose or
frequency without first consulting your doctor.