Take prescribed blood-pressure and cholesterol medicines regularly; do not stop on your own
Lowering blood pressure by 10 mmHg reduces mortality by about 13% and stroke by 27%. Lowering LDL cholesterol by one unit with a statin reduces mortality by about 10%. People taking medicines consistently had 30%–45% lower mortality than frequent missed-dose users.
What it takes
Medicines bought through China's centralized procurement system, including antihypertensives and statins, cost a few to a few dozen renminbi monthly. Daily dosing takes little time; persistence when you feel well is harder.
What you may gain
Meta-analyses of randomized trials found that each 10 mmHg reduction in systolic pressure—the higher reading—reduced mortality by 13% (RR 0.87), major cardiovascular events by 20% (RR 0.80), stroke by 27% (RR 0.73), and heart failure by 28% (RR 0.72). Each 1.0 mmol/L reduction in LDL cholesterol with statins reduced mortality by 10% (RR 0.90) and major vascular events by 22% (RR 0.78). A separate observational meta-analysis found that taking at least 80% of prescribed doses was associated with lower mortality than poor adherence: 45% lower for statins (RR 0.55) and 29% lower for antihypertensives (RR 0.71).
Context & considerations
This is for people whose clinician has determined that medication is indicated; healthy people should not take it automatically. Adherence figures are observational, and consistent medicine users may be more conscientious generally, exaggerating the apparent benefit. The randomized blood-pressure and statin findings are more reliable. Glucose lowering is not listed separately because evidence that more intensive control reduces all-cause mortality is less consistent.
Research & references
Ettehad D et al. (2016). Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. https://doi.org/10.1016/S0140-6736(15)01225-8 ; Cholesterol Treatment Trialists' (CTT) Collaboration (2010). Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Lancet. https://doi.org/10.1016/S0140-6736(10)61350-5 ; Chowdhury R et al. (2013). Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. European Heart Journal. https://doi.org/10.1093/eurheartj/eht295