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Systematic review and meta-analysis
Benefits of blood pressure lowering are seen across levels of baseline blood pressure, comorbidity and drug class
  1. Mark R Nelson
  1. Correspondence to: Professor Mark R Nelson, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7001, Australia; mark.nelson{at}

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It has been long established that reducing blood pressure with pharmacotherapeutic agents prevents adverse cardiovascular disease events, but questions remain about which patients warrant antihypertensive therapy. Historically, this has been determined by the level of blood pressure alone. However, the evidence suggests that individuals most likely to benefit from blood pressure lowering therapy are those at greatest absolute risk of these events. Ettehad and colleagues have conducted a systematic review and meta-analysis investigating the extent to which treatment effects differ by baseline blood pressure and the presence of comorbidities, as well as a comparison of drug class efficacy.


MEDLINE was searched for large-scale trials of blood pressure-lowering agents, published between …

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  • Competing interests During the past 20 years, MRN has participated in trials that have received funding from SmithKline Beecham, AstraZeneca, Bayer, Sanofi-Aventis, Merck Sharpe and Dohme, Pfizer, Servier Laboratories and Bristol-Myers Squibb. MRN has served on advisory boards for Sanofi-Aventis, Novartis, Schering-Plough, Solvay Pharmaceuticals and AMGEN. MRN has prepared educational material for Servier Laboratories, AstraZeneca Bristol-Myers Squibb and MediMark. MRN has received conference and travel support from Bayer HealthCare AG, Merck Sharpe and Dohme, Novartis and Sanofi-Aventis.

  • Provenance and peer review Commissioned; internally peer reviewed.