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Health & Medicine for Senior Citizens

High Blood Pressure Meds Protect Cardiovascular Patients from Stroke, Death

Many studies show persons with CVD can obtain significant benefit from antihypertensive treatments

March 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 percent.

Cardiovascular diseases include,
    ● High blood pressure
    ● Coronary heart disease
        Myocardial infarction
        Angina pectoris (chest pain or discomfort caused by reduced blood supply to the heart muscle)
    ● Stroke
    ● Heart Failure


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"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 write.

"Prehypertension 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."

Editorial: 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.

Types of high blood pressure medications:

   > Angiotensin-Converting Enzyme (ACE) Inhibitors
   > Diuretics
   > Beta Blockers
   > Angiotensin-2 Receptor Antagonists
   > Calcium Channel Blockers

>> To read more about these medications at the AHA website, Click Here


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