Imperial College London
Dr Ajay K Gupta

Dr Ajay K Gupta

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 3437a.k.gupta Website

 
 
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Location

 

ICCH59/61 North Wharf RoadSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rahimi:2021:10.1016/S0140-6736(21)01921-8,
author = {Rahimi, K and Bidel, Z and Nazarzadeh, M and Copland, E and Canoy, D and Wamil, M and Majert, J and McManus, RJ and Chalmers, J and Davis, BR and Pepine, CJ and Teo, KK},
doi = {10.1016/S0140-6736(21)01921-8},
journal = {The Lancet},
pages = {1053--1064},
title = {Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis},
url = {http://dx.doi.org/10.1016/S0140-6736(21)01921-8},
volume = {398},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe effects of pharmacological blood-pressure-lowering on cardiovascular outcomes in individuals aged 70 years and older, particularly when blood pressure is not substantially increased, is uncertain. We compared the effects of blood-pressure-lowering treatment on the risk of major cardiovascular events in groups of patients stratified by age and blood pressure at baseline.MethodsWe did a meta-analysis using individual participant-level data from randomised controlled trials of pharmacological blood-pressure-lowering versus placebo or other classes of blood-pressure-lowering medications, or between more versus less intensive treatment strategies, which had at least 1000 persons-years of follow-up in each treatment group. Participants with previous history of heart failure were excluded. Data were obtained from the Blood Pressure Lowering Treatment Triallists' Collaboration. We pooled the data and categorised participants into baseline age groups (<55 years, 55–64 years, 65–74 years, 75–84 years, and ≥85 years) and blood pressure categories (in 10 mm Hg increments from <120 mm Hg to ≥170 mm Hg systolic blood pressure and from <70 mm Hg to ≥110 mm Hg diastolic). We used a fixed effects one-stage approach and applied Cox proportional hazard models, stratified by trial, to analyse the data. The primary outcome was defined as either a composite of fatal or non-fatal stroke, fatal or non-fatal myocardial infarction or ischaemic heart disease, or heart failure causing death or requiring hospital admission.FindingsWe included data from 358 707 participants from 51 randomised clinical trials. The age of participants at randomisation ranged from 21 years to 105 years (median 65 years [IQR 59–75]), with 42 960 (12·0%) participants younger than 55 years, 128 437 (35·8%) aged 55–64 years, 128 506 (35·8%) 65–74 years, 54 016 (15·1%) 75–84 years, and
AU  - Rahimi,K
AU  - Bidel,Z
AU  - Nazarzadeh,M
AU  - Copland,E
AU  - Canoy,D
AU  - Wamil,M
AU  - Majert,J
AU  - McManus,RJ
AU  - Chalmers,J
AU  - Davis,BR
AU  - Pepine,CJ
AU  - Teo,KK
DO  - 10.1016/S0140-6736(21)01921-8
EP  - 1064
PY  - 2021///
SN  - 0140-6736
SP  - 1053
TI  - Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis
T2  - The Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(21)01921-8
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000697368600017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.sciencedirect.com/science/article/pii/S0140673621019218?via%3Dihub
UR  - http://hdl.handle.net/10044/1/92001
VL  - 398
ER  -
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