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In this review, we outline the rationale for targeting blood pressure and blood cholesterol lowering drug treatments to patients at high absolute cardiovascular risk, irrespective of their blood pressure or blood cholesterol levels. Because the specific levels of blood pressure and cholesterol are of little clinical relevance when considered in isolation from other risk factors, terms such as hypertension or hypercholesterolaemia have limited value. Separate management guidelines for raised blood pressure and blood cholesterol need to be replaced by integrated cardiovascular risk management guidelines, and absolute cardiovascular risk prediction scores should be used routinely. Since cardiovascular risk factors interact with each other, moderate reductions in several risk factors can be more effective than major reductions in one. An affordable daily pill combining low doses of various drugs could be useful for the many individuals with slightly abnormal cardiovascular risk factors.

Original publication

DOI

10.1016/S0140-6736(05)17833-7

Type

Journal article

Journal

Lancet

Publication Date

29/01/2005

Volume

365

Pages

434 - 441

Keywords

Adult, Aged, Blood Pressure, Cardiovascular Diseases, Cholesterol, Female, Humans, Hypercholesterolemia, Hypertension, Male, Middle Aged, Quality-Adjusted Life Years, Risk Assessment, Risk Factors