Should I Take Blood Pressure-Lowering Medications That Have Other Benefits Instead?

— -- Question: I have heard that some blood pressure-lowering medications have other benefits. Should I be taking those medications instead?

Answer: There's been a story that's unfolded over the last 10 to 15 years which has the following title -- give a medication and look for an outcome that goes beyond the reduction in blood pressure. Two drug classes have been highlighted in that regard. The first, angiotensin converting enzyme inhibitors -- otherwise known as ACE inhibitors -- or the second, angiotensin receptor blockers -- otherwise known as ARBs. Now, the thought was that these drugs by the particular way that they interrupted pathways in the body that controlled blood pressure and organ disease, would then confer additional benefit beyond what the blood pressure number was that was achieved. And it was an elegant theory as it unfolded. But as time has gone on, what we now appreciate is it is about how well you can lower the blood pressure number itself. So the lower you bring the blood pressure number -- for example a top number or systolic value of 120 to 130 if not a little bit lower, you actually get most of your benefit from the blood pressure reduction, and a shrinking amount of gain for outcomes by the special class of drug that's used. So if you look at it right now really the trick is get the pressure as low as you can, once you've got it as low as you can get it, then you worry about the regiment is configured or cobbled together, which drugs are added to the other. But it is about the blood pressure number more primarily.