Friday December 19, 2003
NEW YORK (Reuters Health) – Blood pressure lowering may lead to gains of more than two years in life expectancy in some patients, according to researchers.
Dr. Howard. D. Sesso, of Brigham and Women’s Hospital, Boston, and colleagues used a cardiovascular disease event Markov model to estimate life expectancy benefits of antihypertensive treatment, based on systolic and diastolic blood pressure reduction.
They used prospective data from 57,573 subjects, and defined seven patient states: no cardiovascular disease, stroke, myocardial infarction, revascularization, history of cardiovascular disease, non-cardiovascular disease death, and cardiovascular death.
“Risk functions were developed from gender-specific multivariate Cox proportional hazards models for primary events and age-, smoking-, and diabetes-adjusted models for secondary events,” Dr. Sesso and colleagues write in the medical journal Hypertension.
Baseline assumptions included hypothetical pretreatment blood pressures of 160/95 or 150/90 mm Hg; strategies that lowered blood pressure by 20/13 mm Hg (strategy A) or by 13/8 mm Hg (strategy B); and age of 35 years.
Among subjects with an initial blood pressure of 160/95 mm Hg, strategy A produced gains in life expectancy of 2.43 years for hypertension alone and of 2.80 years for hypertension plus diabetes. A gain of 2.43 years was seen for smokers with hypertension and diabetes. Similar gains were observed in individuals with an initial blood pressure of 150/90 mm Hg.
Furthermore, for individuals with an initial blood pressure of 160/95, strategy A provided additional life expectancy gains compared with strategy B.
Sesso’s group also found that “initial blood pressure level did not affect the magnitude of life expectancy gains for equivalent blood pressure reductions.”
Overall, the findings suggest that lowering blood pressure in hypertensive patients, especially those with other cardiovascular disease risk factors such as diabetes or smoking, “has the potential to provide substantial gains in life expectancy.”
SOURCE: Hypertension, November 2003.