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Blood pressure drugs can cut risk of stroke, even at high-normal levels

By Linda Searing,

For people with high-normal blood pressure, drugs may cut stroke risk

THE QUESTION People whose blood pressure is near but not quite high enough for a hypertension diagnosis usually try to lower it by losing weight, eating more healthfully and exercising more. Might there be advantages in adding medication to that mix?

THIS STUDY analyzed data from 16 studies, involving 70,664 people described as pre-hypertensive, with blood pressure readings between 120 and 139 mm Hg systolic (top number) and 80 and 89 diastolic (bottom number). They had been randomly assigned to take an anti-hypertensive drug or a placebo; drugs included ACE inhibitors, calcium channel blockers and angiotensin-receptor blockers. The study periods ranged from one to six years. No differences between the groups were found in the rate of heart attacks, but those who took any type of anti-hypertensive medication had a 22 percent lower chance of having a stroke than those who took a placebo. Risk was lowest for those taking ACE inhibitors and calcium channel blockers.

WHO MAY BE AFFECTED? People with blood pressure at the high end of the normal range, which includes an estimated one of every four adults in the United States. Having hypertension increases the risk for a heart attack, stroke, heart failure and kidney failure.

CAVEATS Some studies included participants who had had hypertension in the past but had blood pressure in the pre-hypertensive range when their study began. Data did not include information on the type and severity of strokes.

FIND THIS STUDY Dec. 8 online issue of Stroke (stroke.ahajournals.org).

LEARN MORE ABOUT high blood pressure at www.nhlbi.nih.gov/hbp and www.heart.org (click “Conditions”).

— Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.

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