Treatment with BP meds reduces risk even without high blood pressure

Published in the March 2 issue of JAMA is a meta-analysis of 25 trials. Each trial had patients with cardiovascular disease, but without a diagnosis of high blood pressure and randomly administered either a blood pressure medication or placebo. The authors found that the risk of heart attack was reduced by 20%, stroke was reduced by 23%, and death was reduced by 13%. Unfortunately, the studies used a mix of medicines, and the authors did not tease out the differences in benefit between ACE inhibitors, beta-blockers, and calcium channel blockers. Each type of drug is useful in lowering blood pressure, but we do not know which one (or ones) are beneficial at reducing these other risks.