Tailored medicine could prevent more heart attacks

(Reuters Health) — National guidelines help doctors decide how to treat high blood pressure. But tailoring those guidelines to better fit individuals could prevent many more heart attacks and strokes, say developers of a computer model that makes those calculations.

Their study, published Monday in the Annals of Internal Medicine, estimated the effects of using “individualized guidelines” to make decisions on treating high blood pressure.

It found that the tailored approach could prevent 43 percent more heart attacks and strokes than the simpler, general recommendations used now.

Currently, U.S. guidelines recommend treatment if blood pressure rises above 140/90 mm Hg, or above 130/80 mm Hg if a person has diabetes or chronic kidney disease.

Doctors generally add their own judgment to that decision as well. If, for instance, a person has slightly elevated blood pressure but is otherwise at low risk for heart problems, then lifestyle changes might be enough.

But the new study looked at a more sophisticated way of estimating individual patients’ needs. Researchers used a computer-based “risk calculator” that took into account a person’s age, cholesterol levels, family history of heart disease and any diabetes diagnosis.

It also factored in what’s known about different types of patients’ responses to various blood pressure medications.

The researchers then used data from a long-term study of 15,800 Americans to estimate the effects of applying the individualized guidelines.


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