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‘Prescribe antihypertensives for all over a certain age’

By Nigel Praities

Antihypertensives should be prescribed in all patients whose age puts them at risk of a CV event, regardless of their pre-treatment blood pressure, say British researchers.

Their meta-analysis of 108 trials of patients aged 60-69 suggests GPs should abandon measuring blood pressure routinely and prescribe antihypertensives to everyone old enough to be at risk of a heart attack or stroke.

The study published in the BMJ found a consistent 22% reduction in coronary events and a 41% reduction in stroke for a blood pressure reduction of 10mmHg systolic or 5mmHg diastolic.

The percentage reduction in the coronary heart disease events and stroke was the same regardless of blood pressure – down to 110mmHg systolic and 70mmHg diastolic – or any history of CVD.

Professor Malcolm Law, professor of epidemiology at Queen Mary University of London, said: ‘The results show that blood pressure lowering drugs should be offered to anyone at sufficient risk to benefit from treatment, whatever their reason for being at risk.'

But Dr John Pittard, a GP in Staines, Middlesex, and hospital practitioner in cardiology, said blanket prescribing of hypertensives would not be practical.

‘If you just tell everybody you must take blood pressure pills from 60, it might work from a population point of view, but in my experience, the last thing people want to do is take a pill.'

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