Because it provides stronger evidence than ever before of the relationship between blood pressure and the risk of coronary heart disease (CHD) and stroke for people at any age. The study, funded by the British Heart Foundation (BHF) and the Medical Research Council (MRC), analyzed data from 61 worldwide observational studies of blood pressure and mortality demonstrating direct evidence of strong links to CHD and stroke.

Although the finding that blood pressure is a predictor of vascular disease is not new, it was previously not fully appreciated how strongly it was related to vascular mortality even among people in their seventies and eighties, nor that the relationship was so strong and continuous throughout regardless of the initial level of blood pressure (down at least as far as 115/75 mm Hg).

Not only do the present analyses confirm that there is a continuous relationship with risk throughout the normal range of usual blood pressure (down at least as far as 115/75 mm Hg), but they also demonstrate that within this range the usual blood pressure is even more strongly related to vascular mortality than had previously been supposed. Randomized trials (which typically last only a few years) have shown that blood pressure lowering can produce rapid reductions in vascular disease risk, and this meta-analysis provides complementary evidence of the even greater differences in risk that are likely to be produced by really prolonged differences in blood pressure.

This work continued from an earlier analysis of cholesterol, blood pressure, and stroke published in the Lancet in 1995.

Sarah Lewington, DPhil
Radcliffe Infirmary
Clinical Trial Service Unit & Epidemiological Studies Unit
University of Oxford, UK