New classes of blood pressure-lowering drugs could save lives by preventing strokes and heart attacks even more effectively, a major trial says.
The newer therapies worked much better
Experts believe prescribing practices should change immediately based on the Ascot study's conclusions.
New drugs not only lower blood pressure to a greater extent than older ones, but also attack cholesterol, halving the stroke and heart attack risk.
The trial was stopped early because the results were so staggering.
The outstanding cholesterol-lowering findings were discovered back in 2002 - five years after the planned 10-year trial began in 1997.
The researchers continued to compare the blood pressure effects, but terminated this part of the study early as well last December after it became clear that the newer antihypertensive drugs were also better at lowering blood pressure.
The latest report in the Lancet is the first time that the researchers have pulled together all of their results.
Patients with high blood pressure taking a relatively new type of cholesterol-lowering medication called a statin benefited from a 36% reduction in heart attacks and a 27% reduction in strokes compared to those not prescribed that specific medication.
Patients taking newer blood pressure treatments (calcium channel blockers and ACE inhibitors) benefited from a 25% reduction in strokes and a 15% reduction in heart attacks compared with those taking older ones (beta blockers and diuretics).
Overall, the risk of death from strokes and heart attacks was reduced by 24% with the newer drugs compared with the older ones.
The researchers, from the UK and Scandinavia, said the results should provide reassurance and guidance for doctors and patients alike.
Saving more lives
Professor Peter Sever, from Imperial College London, said: "The outcome of the Ascot study is very, very pleasing.
"We can be reassured that these reductions in heart attacks and strokes are very real and are very worthwhile."
Experts say these newer drugs should now be used more frequently and current guidelines should be updated.
The National Institute for Health and Clinical Excellence (Nice) and the British Hypertension Society announced earlier this week that they would look at the Ascot data and make recommendations soon.
Professor Peter Littlejohns of Nice said: "Nice guidelines are not usually considered for updating until four years after publication.
"However in this case, Nice feels it is appropriate to look at this data in the context of our existing recommendations and to see whether any revision might be made."
NICE said this process could take around six months.
Professor Peter Weissberg, medical director of the British Heart Foundation, said: "We expect that this study will have a major influence on future guidelines published by organisations such as NICE and consequently on future prescribing of antihypertensive drugs.
"However, people taking the older types of drug should however, be reassured that they are on effective treatment and there may be good medical reasons why they should continue on these drugs, rather than swap to the newer ones."