Abstract
With the exception of the extra protective effect of beta blockers given shortly after a myocardial infarction and the minor additional effect of calcium channel blockers in preventing stroke, all the classes of blood pressure lowering drugs have a similar effect in reducing CHD events and stroke for a given reduction in blood pressure so excluding material pleiotropic effects. The proportional reduction in cardiovascular disease events was the same or similar regardless of pretreatment blood pressure and the presence or absence of existing cardiovascular disease. Guidelines on the use of blood pressure lowering drugs can be simplified so that drugs are offered to people with all levels of blood pressure. Our results indicate the importance of lowering blood pressure in everyone over a certain age, rather than measuring it in everyone and treating it in some.
Keywords
MedicineBlood pressureStroke (engine)Context (archaeology)Myocardial infarctionPlaceboClinical trialMeta-analysisInternal medicineRandomized controlled trialRelative riskConfidence intervalIntensive care medicinePhysical therapyAlternative medicinePathology
Affiliated Institutions
Related Publications
Effect of Antihypertensive Treatment in Patients Having Already Suffered From Stroke
Background and Purpose Drug treatment of high blood pressure has been shown to reduce the associated cardiovascular risk. Stroke represents the type of event more strongly linke...
Effect of Antihypertensive Drug Treatment on Cardiovascular Outcomes in Women and Men
Background: Trials of drug therapy for hypertension have shown that such therapy has a clear overall benefit in preventing cardiovascular disease. Although these trials have inc...
Effects of blood pressure lowering on outcome incidence in hypertension. 1. Overview, meta-analyses, and meta-regression analyses of randomized trials
Meta-analyses of all BP-lowering RCTs involving hypertensive patients provide precise estimates of benefits (larger for stroke and heart failure, but also significant for CHD an...
Decline in Cardiovascular Mortality
If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and st...
Blood pressure, antihypertensive drug treatment and the risks of stroke and of coronary heart disease
Most evidence about the effects of blood pressure on the risks of cardiovascular disease derives from two principal sources: prospective non-randomised observational studies of ...
Publication Info
- Year
- 2009
- Type
- review
- Volume
- 338
- Issue
- may19 1
- Pages
- b1665-b1665
- Citations
- 2727
- Access
- Closed
External Links
Social Impact
Altmetric
PlumX Metrics
Social media, news, blog, policy document mentions
Citation Metrics
2727
OpenAlex
Cite This
M R Law,
Joan K. Morris,
Nicholas Wald
(2009).
Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies.
BMJ
, 338
(may19 1)
, b1665-b1665.
https://doi.org/10.1136/bmj.b1665
Identifiers
- DOI
- 10.1136/bmj.b1665