New online tool to transform how high blood pressure is treated

NEW DELHI — A global team of researchers from India, Australia, the US, and the UK has developed a novel online-based tool which can transform how hypertension is managed, allowing doctors to choose a treatment for each patient based on the degree to which they need to lower their blood pressure.

The 'blood pressure treatment efficacy calculator' is built on data from nearly 500 randomised clinical trials in over 100,000 people. It allows doctors to see how different medications are likely to lower blood pressure.

“We cannot overlook the importance of controlling high blood pressure effectively and efficiently. Achieving optimal control requires a clear understanding of the efficacy of antihypertensive drugs at different doses and in various combinations. Without clarity on what we want to achieve and how to achieve it, we will not meet our targets. Guidelines define the target blood pressure, while our online tool helps identify which antihypertensive drugs are best suited to reach that target,” said Dr. Mohammad Abdul Salam, from The George Institute for Global Health, Hyderabad.

A single antihypertensive medication -- still the most common way treatment is started -- typically lowers systolic BP by just 8-9 mmHg, while most patients need reductions of 15-30 mmHg to reach ideal targets.

Nelson Wang, cardiologist and Research Fellow at the Institute, noted that while the traditional way of doing this is by measuring blood pressure directly for each patient and adjusting treatment accordingly, BP readings are far too variable, or ‘noisy’, for it to be reliable.

The new tool, described in research published in The Lancet, helps overcome this challenge by calculating the average treatment effect seen across hundreds of trials.

It also categorises treatments as low, moderate, and high intensity, based on how much they lower blood pressure (BP) -- an approach already routinely used in cholesterol-lowering treatment.

High blood pressure is one of the world’s biggest health challenges, affecting as many as 1.3 billion people and leading to around ten million deaths each year.

Often called a silent killer as it does not cause any symptoms on its own, it can remain hidden until it leads to a heart attack, stroke, or kidney disease. Fewer than one in five people with hypertension have it under control.