'Let all over-50s have blood pressure pills': Tablets should be considered for all older patients even if they do not have symptoms, heart professor says
Blood pressure tablets should be considered for all over-50s even if they do not have high blood pressure, according to an Oxford professor.
The pills have been found to reduce the risk of strokes, heart attacks, heart disease and heart failure in older people, even if their blood pressure was normal to start with.
Professor Kazem Rahimi led a team analyzing more than 350,000 people given blood pressure tablets – such as ACE inhibitors and beta blockers – or a dummy pill.
People aged 55 to 84 were 9 per cent less likely to suffer a cardiovascular event for every small drop in their blood pressure – which could be achieved by taking one daily tablet.
Oxford professor believes blood pressure tablets should be given to all over-50s as study finds they reduce risk of stroke, heart attacks, heart disease and heart failure (stock image)
The professor of cardiovascular medicine said: ‘We saw a reduction in risk among people who were in the normal range for blood pressure, or where it was moderately elevated, as well as in those with high blood pressure.
‘That suggests everyone aged 50 or over should be considered for blood pressure tablets.
‘GPs are often cautious in prescribing these drugs because they don’t want to over-medicalise people with normal blood pressure, but this study shows these preventative drugs reduce the risk of heart attacks and strokes for these people, in all age groups.’
Critics argue that artificially lowering blood pressure could reduce blood flow to the heart and brain, potentially causing memory problems or strokes. But the study authors found no evidence of increased deaths among older people given blood pressure tablets. Their analysis, published in The Lancet medical journal, looked at 358,707 people from 51 separate studies on blood pressure pills.
They were followed up for an average of four-and-a-half years to see if they suffered heart attacks, strokes or heart disease, and if they were taken to hospital with heart failure or died from it.
The risk of these events was reduced by 22 per cent in under-55s for every 5mm reduction in their systolic blood pressure – the lower number in a blood pressure reading. The risk was cut by 9 per cent in people aged 55 to 84 for each 5mm reduction in blood pressure – which can be achieved by taking approximately one tablet.
Professor Kazem Rahimi (pictured) led a team analysing more than 350,000 people given blood pressure tablets – and found people aged 55 to 84 were 9% less likely to suffer a cardiovascular event
The actual rate of cardiovascular events was reduced more in older people given blood pressure-lowering medications, because they tend to suffer more heart attacks and strokes so benefit more from treatment. The effect on the risk of cardiovascular events was similar for those with all rates of blood pressure. Treatment is only routinely given to people with substantially elevated high blood pressure.
The National Institute for Health and Care Excellence says that over-80s in the UK should have blood pressure below 150/90. Professor Rahimi suggests age-based guidance like this should be scrapped.
His team did not find a significant reduction in the risk of cardiovascular events for people aged 85 and over, but only a small number of these were available for analysis.
He said: ‘Older people have an increased risk of heart attacks and strokes, so doctors should not withhold blood pressure tablets from them. It would be simple to calculate their risk, and whether the drugs are needed, based on factors such as age, blood pressure, their cholesterol level, whether they smoke and if they have diabetes.’
Professor Sir Nilesh Samani, of the British Heart Foundation, which helped to fund the research, said: ‘Our risk of heart attack and stroke increases as we age and this study reinforces the importance of controlling blood pressure to reduce that risk.’
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