HypertensionMeta-analysis
A meta-analysis of the long-term effects of antihypertensive therapy on the risk of major cardiovascular disease across 51 randomized trials
- Individual participant-level data meta-analysis of randomised trials
- Blood Pressure Lowering Treatment Trialists' Collaboration
- time-stratified Cox models
- network meta-analysis by drug class
Authors' conclusion
These findings indicate that the relative cardiovascular benefits of BP lowering emerge within months and do not increase over time
Study context
- Population
- Participants in randomised trials of blood pressure (BP)-lowering therapy
- Participants
- 358,642 participants · 51 RCTs
- Comparison
- BP-lowering therapy vs control
- Outcome
- MACE (fatal or non-fatal stroke, ischemic heart disease or HF), time-stratified HR per 5-mmHg SBP reduction
- Follow-up
- Annual intervals up to >5 years
Pooled result
As reported in the abstract
MACE per 5-mmHg SBP reduction, by annual follow-up interval
MACE per 5-mmHg SBP reduction, by annual follow-up interval
Annual MACE incidence, >5 years
- Benefits established early, not progressively increasing over time; P for trend
- P for trend = 0.006
Further pooled results
Annual MACE incidence, >5 years
Temporal pattern by drug class
- Similar patterns across five drug classes
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
A meta-analysis of the long-term effects of antihypertensive therapy on the risk of major cardiovascular disease across 51 randomized trials. Nat Med. Published 1 July 2026. doi:10.1038/s41591-026-04514-3
Summarised from the published abstract; every number is checked against it