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January 1, 2022The Lancet Healthy LongevityOpen Access

The importance of blood pressure thresholds versus predicted cardiovascular risk on subsequent rates of cardiovascular disease: a cohort study in English primary care

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Why the study?

Guidelines have increasingly incorporated predicted cardiovascular disease risk alongside reducing blood pressure thresholds, but data assessing the relative importance of blood pressure thresholds versus predicted risk on subsequent cardiovascular disease rates were needed to inform treatment decisions.

Does predicted 10-year cardiovascular risk better predict cardiovascular disease rates than systolic blood pressure thresholds in adults aged 30-79?

Population

1 098 991 patients aged 30-79 years in England

Comparison

Stratification by systolic blood pressure vs predicted 10-year cardiovascular risk

Design

Population-based cohort study

Follow-up

Median of 4·3 years

Discussion

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Member takes

Overview

May delay drugs for lifestyle attempts if predicted risk is low; leaves open de-emphasizing 140/90 thresholds in guidelines.

Structured PICO

Does predicted 10-year cardiovascular risk better predict cardiovascular disease rates than systolic blood pressure thresholds in adults aged 30-79?

P
Population
1,098,991 adults aged 30-79 years in English primary care, median age 52, 57.3% female.
O
Outcome
Cardiovascular diseasehard clinical

Predicted 10-year cardiovascular risk is a much stronger determinant of subsequent cardiovascular disease rates than isolated systolic blood pressure thresholds, suggesting risk-based rather than threshold-based treatment initiation is more effective.

Cite This Study

A 2022 study studied this question.

synapsesocial.com/papers/6a7f549d375bfe41b7b3d70bhttps://doi.org/10.1016/s2666-7568(21)00281-6
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Eligibility and subsequent burden of cardiovascular disease of four strategies for blood pressure-lowering treatment: a retrospective cohort study2019 · 56 citations
  2. 2Using thresholds based on risk of cardiovascular disease to target treatment for hypertension: modelling events averted and number treated2000 · 55 citations
  3. 3Incident Cardiovascular Disease Among Adults With Blood Pressure <140/90 mm Hg2017 · 76 citations
  4. 4Effects of blood pressure lowering on outcome incidence in hypertension2014 · 121 citations
  5. 5Blood pressure targets for the treatment of people with hypertension and cardiovascular disease2017 · 71 citations