Sophia Antipolis, France – 31 Aug 2020: Blood pressure medication can prevent heart attacks and strokes – even in people with normal blood pressure. That’s the finding of late breaking research presented in a Hot Line session today at ESC Congress 2020.
2020年8月31日在ESC 2020大会的热线研究专场公布的BPLTTC试验最新研究结果显示：降压药可以预防心脏病和脑卒中——即使对血压正常的人也是如此。
“Greater drops in blood pressure withmedication lead to greater reductions in the risk of heart attacks andstrokes,” said principal investigator Professor Kazem Rahimi of the Universityof Oxford, UK. “This holds true regardless of the starting blood pressurelevel
, in people who previously had a heart attack or stroke, and in people whohave never had heart disease.”
主要研究者、英国牛津大学的Kazem Rahimi教授（图1）说：“通过药物治疗，大幅度降低血压，从而大大降低心脏病和脑卒中的风险。不管起始血压水平如何，这一点在既往有过心脏病发作或脑卒中的人和从未患过心脏病的人中都适用。”
图1. Kazem Rahimi教授在线汇报BPLTTC研究结果
“The fact that the relative effects aresimilar for everyone does not mean that everyone should be treated,” he added.“This decision will depend on an individual’s likelihood of sufferingcardiovascular disease in the future – there are a number of risk calculatorshealth professionals can use. Other factors to consider are the potential forside effects and the cost of treatment.”
他补充道，事实上每个人的相对效果都是相似的，但这并不意味着每个人都应该接受治疗。这取决于每个人未来患心血管疾病的可能性——专业人员可以通过许多方法评估。其潜在的副作用和治疗费用也是需要考虑的因素。
There has been controversy about whetherpharmacological blood pressure lowering is equally beneficial in people withversus without a prior heart attack or stroke, and when blood pressure is belowthe threshold for hypertension (typically 140/90 mmHg). Evidence from previousstudies has been inconclusive, leading to contradictory treatmentrecommendations around the world.
对既往有心脏病发作或脑卒中史，以及血压低于高血压阈值（通常为140/90 mmHg）的人，药物降压是否同样有益，这一问题一直存在争议。以往研究还没有定论，导致世界各地的治疗建议相互矛盾。
This was the largest – and most detailed –study ever conducted to examine these questions. The researchers combined dataon individuals who had participated in a randomised clinical trial andconducted a metaanalysis. The study included 348,854 participants from 48trials.
这是迄今为止针对这些问题进行的规模最大、最详细的研究。综合了参与随机临床试验的个体数据，并进行了元分析。研究包括来自48个试验的348,854名参与者。
Participants were divided into two groups:those with a prior diagnosis of cardiovascular disease and those without. Eachgroup was divided into seven subgroups based on systolic blood pressure atstudy entry (less than 120, 120-129, 130-139, 140-149, 150-159, 160-169, 170and above mmHg).
参与者被分成两组：一组有心血管疾病的病史，另一组没有。根据研究开始时的收缩压（＜120、120-129、130-139、140-149、150-159、160-169、≥170 mmHg）将各组分为七个亚组。
Over an average four years of follow-up,each 5 mmHg reduction in systolic blood pressure lowered the relative risk ofmajor cardiovascular events by about 10%. The risks for stroke, ischaemic heartdisease, heart failure and death from cardiovascular disease were reduced by13%, 7% and 14% and 5%, respectively.
在平均4年的随访中，收缩压每降低5 mmHg，主要心血管事件的相对风险降低约10%。脑卒中、缺血性心脏病、心力衰竭和心血管疾病死亡的风险分别降低了13%、7%、14%和5%（图2）。
