A new online tool is set to revolutionise how high blood pressure is treated, experts say, and it’s already freely available.
Choosing the most appropriate blood pressure treatment based on specific target reduction is now quick, easy and thoroughly based in updated evidence.
The Blood Pressure Treatment Efficacy Calculator, which was built on data from nearly 500 randomised clinical trials in over 100,000 people, is accessible for free online.
Prescribers simply select one or more hypertensive therapies and dosages from a dropdown menu, and the calculator predicts the efficacy of the treatment regimen.
The tool shows the average reduction in systolic and diastolic blood pressure over four weeks based on various baseline BPs.
You also have the option to include your patient’s baseline BP and their cardiovascular risk percentage for more tailored estimates.
“With dozens of drugs, multiple doses per drug, and most patients needing two or more drugs, there are literally thousands of possible options and no easy way to work out how effective they are,” Dr Nelson Wang, cardiologist and research fellow at The George Institute for Global Health, told media.
He said that enabling doctors to choose patient-specific treatment based on the degree to which they need to lower their blood pressure is important, given that for every 1mmHg reduction in SBP, heart attack or stroke risk drops by 2%.
The calculator also categorises each treatment as low, moderate or high intensity regimen, based on 0-9.9, 10-19.9, and ≥20mmHg SBP reduction respectively from a theoretical baseline of 154mmHg.
According to The George Institute for Global Health, antihypertensive treatment is most commonly initiated with a single medication.
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However, most patients need reductions of 15-30mmHg to reach ideal targets and monotherapy typically only lowers SBP by 8-9mmHg.
Professor Anthony Rodgers, senior professorial fellow at The George Institute for Global Health, said that despite hypertension being the most common reason for GP visits, there had been no single, up-to-date resource to show how effective different blood pressure medications are at various doses or when used in combination.
“With this new method, you specify how much you need to lower blood pressure, choose an ideal treatment plan to achieve that based on the evidence, and get the patient started on that ideally sooner rather than later,” Professor Rodgers said.
He explained that using the traditional “start low, go slow, measure and judge” approach to treatment comes with high probability of being misled by BP readings or treatment inertia setting in.
While measuring blood pressure directly for each patient and adjusting treatment accordingly is the traditional way to treat hypertension, normal BP fluctuations could misrepresent the efficacy of the chosen treatment, Dr Wang said.
“Also, measurement practices are often not perfect, bringing in an additional source of uncertainty – this means it’s very hard to reliably assess how well a medicine is working just by taking repeated measurements,” he said.
Professor Rodgers told media that even modest improvements to blood pressure would have a large public health impact.
“Increasing the percentage of people whose hypertension is under control globally to just 50% could save many millions of lives,” he said.
