Herrett E, Gadd S, Jackson R, et al. - In order to examine the implications of alternative approaches for offering blood pressure treatment, using the UK as an illustrative example, researchers used a retrospective cohort study in primary care 1,222,670 patients aged 30–79 years without cardiovascular disease. A total of 32,183 patients during follow-up were diagnosed with cardiovascular disease. In patients eligible for each strategy, cardiovascular event rates were 15·2 per 1,000 person-years under the 2011 National Institute for Health and Care Excellence (NICE) guideline, 14·9 under the proposed 2019 NICE guideline, 11·4 with blood pressure threshold alone, and 16·9 with QRISK2 threshold alone. Scaled to the UK population, it was estimated that 233,152, 270,233, 301,523, and 322,921 events would be avoided under the 2011 NICE guideline, the 2019 NICE guideline, using a blood pressure threshold, and using QRISK2 threshold, respectively. In conclusion, a cardiovascular risk-based strategy (QRISK2 ≥ 10%) could prevent over a third more cardiovascular disease events than the 2011 NICE guideline and a fifth more than the 2019 NICE guideline, with comparable efficacy regarding number treated per event avoided.