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Aggressive BP care caution

Primary care researchers warn GPs that following 'aggressive' guidelines for lowering blood pressure in stroke patients could do more harm than good.

They called for caution after their analysis of the landmark PROGRESS trial ­ which led to national guidelines advocating intensive blood pressure lowering ­ showed primary care patients were 'very different' from trial participants.

The study, published early online by the BMJ, found GP stroke patients were on average 12 years older than the trial population and had suffered their last cerebrovascular event 30 months ago compared with eight months ago in PROGRESS.

Dr Jonathan Mant, senior lecturer in the department of general practice and primary care, University of Birmingham, said the differences were 'so great' they undermined the applicability of the guidance.

'Maybe GPs ought to be more circumspect about intensively lowering blood pressure, particularly in older patients.

'The more drugs you are on the more side-effects the more risk of postural hypotension the more risk of falls.'

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