A recent study published in the journal Hypertension highlights evolving perspectives on managing high blood pressure, underscoring the importance of considering both short-term and long-term cardiovascular risks when deciding on medication. The research reveals that while some individuals may have a low 10-year risk of heart attack or stroke, their 30-year risk remains substantially high.
Cardiovascular
Dr. Paul Muntner, lead author and visiting professor at the University of Alabama at Birmingham, explains, “Many people exhibit low risks for heart attack and stroke over the next decade but face elevated risks over the subsequent 30 years.” This insight prompts a reconsideration of whether individuals should initiate medication, emphasizing the value of comprehending risks over both time frames.
Nearly half of U.S. adults grapple with hypertension, a condition where blood pressure within arteries exerts excessive force, potentially leading to severe health complications like heart disease, stroke, and kidney disease over time.
Previously, decisions to prescribe medication relied on tools assessing 10-year cardiovascular risks, such as the Pooled Cohort Equations (PCEs). However, advancements in understanding cardiovascular disease have prompted the development of updated risk equations, like the PREVENT calculator introduced by the American Heart Association in 2023. PREVENT predicts not only the risk of plaque-related cardiovascular disease over the next decade but also incorporates the risk of heart failure, reflecting contemporary insights and healthcare practices.
The study compared outcomes using both PCEs and PREVENT among adults aged 30 to 79 with stage 1 hypertension. It found that while PCEs estimated a higher 10-year risk compared to PREVENT (5.4% versus 2.9%), PREVENT revealed significantly elevated 30-year risks for those under 60, even when their short-term risks appeared low.
These findings underscore the potential benefits of early intervention with blood pressure-lowering medications alongside lifestyle changes, particularly for individuals facing prolonged elevated risks. Muntner stresses the importance of patient involvement in treatment decisions, advocating for informed discussions that consider individualized cardiovascular risks over different time horizons.
He emphasizes, “Transparent communication about predicted risks empowers patients to make informed decisions about their health. While medication is a critical option, lifestyle modifications such as dietary changes, exercise, weight management, and stress reduction remain pivotal in managing hypertension effectively.”
Understanding one’s long-term risk for heart disease, stroke, or heart failure can motivate proactive health measures, ensuring a proactive approach to mitigating the silent risks posed by hypertension.
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