Ten-year legacy effects of baseline blood pressure 'treatment naivety' in the Second Australian National Blood Pressure study

Journal of Hypertension
Mark R NelsonLindon Wing

Abstract

Current blood pressure (BP) management guidelines recommend that treatment thresholds for BP be based on absolute cardiovascular disease (CVD) risk rather than on elevated BP levels alone. Clinicians are concerned that delayed pharmacotherapy in individuals with high BP, but low CVD risk, may increase long-term CVD events. To investigate this, we examined differences in CVD events within the Second Australian National BP study (ANBP2) for those previously on pharmacotherapy and those who were not, as well as fatal events in the 6-year post-trial period. Population consisted of ANBP2 participants without a prior CVD event. Adjusted Cox-regression hazard models were used to assess the effects of prior BP pharmacotherapy use on cardiovascular endpoints within ANBP2. An extended 6-year follow-up analysis for cardiovascular and all-cause mortality was also conducted. We found a higher in-trial CVD and all-cause mortality rate and incidence of new-onset diabetes for those on previous treatment versus those who were treatment-naive. We investigated whether this was an effect of the in-trial protocol, but this did not explain the observed differences. No difference in CVD or all-cause mortality at 10 years was observed between 'treatme...Continue Reading

References

Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais
Feb 14, 2003·The New England Journal of Medicine·Lindon M H WingUNKNOWN Second Australian National Blood Pressure Study Group
Dec 22, 2011·JAMA : the Journal of the American Medical Association·John B KostisBarry R Davis
Nov 20, 2013·American Journal of Hypertension·Enayet K ChowdhuryUNKNOWN Second Australian National Blood Pressure Study Management Committee
Aug 19, 2014·Lancet·UNKNOWN Blood Pressure Lowering Treatment Trialists' Collaboration

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