In primary prevention , the association of BP-lowering treatment with major cardiovascular events was dependent on baseline systolic BP ( SBP ) .
Conclusions and Relevance Primary preventive BP lowering is associated with reduced risk for death and CVD if baseline SBP is 140 mm Hg or higher .
At lower BP levels , treatment is not associated with any benefit in primary prevention but might offer additional protection in patients with CHD
Importance High blood pressure ( BP ) is the most important risk factor for death and cardiovascular disease ( CVD ) worldwide .
The optimal cutoff for treatment of high BP is debated .
Objective To assess the association between BP lowering treatment and death and CVD at different BP levels .
Effect of metoprolol on death and cardiac events during a 2-year period after coronary artery bypass grafting. The MACB Study Group.
PURPOSE To evaluate the effect of long-term treatment with metoprolol after coronary bypass grafting on death and cardiac events . METHODS Patients in western Sweden on whom coronary artery bypass grafting was performed between June 1988 and June 1991 were evaluated for inclusion during the first 3 weeks after surgery . Major exclusion criteria were age > 75 years , concomitant valve surgery , traditional contraindications to beta-blockers and unwillingness to participate . Patients were r and omized in a double-blind fashion to 100 mg of metoprolol/placebo daily for 2 weeks and thereafter 200 mg daily for 2 years . RESULTS Of 2365 patients who were operated on , 967 were r and omized to either metoprolol ( n = 480 ) or placebo ( n = 487 ) . Primary end points ( death , non-fatal myocardial infa rct ion , unstable angina pectoris , need for coronary artery bypass grafting or percutaneous transluminal angioplasty ) , were reached by 42 patients in the metoprolol group ( 8.8 % ) , as compared with 39 in the placebo group ( 8.0 % ) ( P = 0.73 ) . Of all the patients r and omized to metoprolol , 34 % withdrew from blind treatment prematurely compared with 44 % for placebo ( P < 0.01 ) . CONCLUSION Prophylactic treatment with metoprolol over a 2-year period after coronary artery bypass grafting did not reduce death or the development of cardiac events . However , the 95 % confidence limits ranged from the possibility of a 30 % reduction in events to a 68 % increase in events if patients were treated with metoprolol as compared with placebo
In primary prevention , the association of BP-lowering treatment with major cardiovascular events was dependent on baseline systolic BP ( SBP ) .
Conclusions and Relevance Primary preventive BP lowering is associated with reduced risk for death and CVD if baseline SBP is 140 mm Hg or higher .
At lower BP levels , treatment is not associated with any benefit in primary prevention but might offer additional protection in patients with CHD
Importance High blood pressure ( BP ) is the most important risk factor for death and cardiovascular disease ( CVD ) worldwide .
The optimal cutoff for treatment of high BP is debated .
Objective To assess the association between BP lowering treatment and death and CVD at different BP levels .