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'Offer a BP-lowering drug to all over-55s'

A Government-commissioned strategy for reducing blood pressure has suggested GPs

offer BP-lowering drugs to all patients aged over 55 and all those who have suffered a cardiovascular event.

The authors of the report said this strategy would ensure 98 per cent of patients who would otherwise die from stroke or heart disease were targeted.

But the strategy has been criticised by hypertension experts for its 'unfounded' claims, as there had been no safety, acceptability or cost-

effectiveness trials.

Report authors said the current British Hypertension Society guidelines, which recommend BP-lowering drugs be offered to patients with greater than 100mHg diastolic, limited the number of patients who could be treated.

Lead author Professor Malcolm Law, professor of epidemiology at Queen Mary University of London, said studies had shown age and previous disease should be the 'principal screening test' for identifying antihypertensives.

'Once a first cardiovascular event has occurred the ability of BP and other risk factors to predict recurrent events is very weak,' he added.

The strategy, published as a health technology assessment last week, recommended prescribing BP-lowering drugs such as thiazides, ?-blockers, ACE inhibitors and angio-tensin-2-receptor to all patients over 55. Prescribing one drug would reduce diastolic blood pressure by 4.7mmHg, two in combination by 8.9mmHg and three by 12.6mmHg, the strategy said.

Professor Bryan Williams, professor of medicine at the University of Leicester and chair of the British Hypertension Society, said: 'This strategy has never been formally tested so its safety, acceptability and cost-effectiveness is unknown.'

Dr Stewart Findlay, a GP in Bishop Auckland, Durham, and board member of the

Primary Care Cardiovascular Society, agreed the strategy was good in theory but called for robust clinical trials.

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