People who take blood-pressure lowering medications have a lower risk for major cardiovascular events, no matter their previous diagnoses of heart disease or whether they have normal blood pressure, according to the authors of a new study.

Treatment with anti-hypertensives should therefore be a cornerstone of cardiovascular risk prevention — and not based solely on prior history of cardiovascular disease or blood pressure status, they contend.

In a meta-analysis of individual participant-level data from randomized trials, the effects of those drugs on cardiovascular outcomes were similar in people with or without previous cardiovascular disease and across categories of baseline systolic blood pressure down to less than 120 mm Hg, the authors reported. 

What’s more, the average risk of a major cardiovascular event plummeted by about 10% when there was a 5 mm Hg reduction of systolic blood pressure. And the corresponding proportional risk reductions were 13% for stroke and for heart failure, 8% for ischaemic heart disease and 5% for cardiovascular death.

The findings have important implications for clinical practice, the authors stated. The current approach to blood pressure prescribing typically depends on a patient’s previous history of cardiovascular disease and blood pressure value.

“By using antihypertensives as a tool for reducing cardiovascular risk rather than simply reducing blood pressure, clinicians are no longer required to make decisions according to an arbitrary and confusing classification of hypertension,” investigators said.

The burden of exact blood pressure measurement also is reduced in this model, potentially simplifying decision-making, management and communication of treatment strategies, the authors added. This may in turn lead to more efficient care when compared with strategies that rely more heavily on absolute blood pressure values, they concluded. 

The study was published in The Lancet.