Evidence-based medicine

    The science behind blood pressure treatment

    Decades of research clearly show that lowering blood pressure is one of the most effective measures for preventing cardiovascular disease, stroke and premature death.

    20%

    reduced stroke risk per 10 mmHg blood pressure reduction

    25%

    reduced heart disease risk per 10 mmHg reduction

    10 mmHg

    reduction is enough to significantly lower the risk

    Why blood pressure matters

    High blood pressure (hypertension) is the single greatest risk factor for cardiovascular disease globally. It strains the heart, blood vessels and kidneys and increases the risk of heart attack, stroke, heart failure and kidney failure. Hypertension often causes no symptoms – which is why it is called "the silent killer".

    The good news is that blood pressure can be influenced. Both lifestyle changes and medication have been shown in large clinical trials to significantly reduce morbidity and mortality.

    Key clinical studies

    Here we summarise the most significant studies showing the link between blood pressure reduction and decreased disease.

    SPRINT

    2015 · n = 9 361

    Compared intensive blood pressure treatment (target <120 mmHg) with standard treatment (target <140 mmHg) in patients with high cardiovascular risk but without diabetes.

    25% reduced risk of major cardiovascular events and 27% reduced all-cause mortality in the intensively treated group.

    HOPE-3

    2016 · n = 12 705

    Examined the effect of blood pressure-lowering treatment in people with moderate cardiovascular risk without known cardiovascular disease.

    In participants with systolic blood pressure >143.5 mmHg, a significant 27% reduction in cardiovascular events was observed.

    EMPA-REG OUTCOME

    2015 · n = 7 020

    Showed that empagliflozin, in addition to blood sugar reduction, provided blood pressure lowering and cardiovascular benefits in patients with type 2 diabetes.

    38% reduced cardiovascular mortality and 35% reduced risk of hospitalisation for heart failure.

    Ettehad et al. (metaanalys)

    2016 · n = 613 815

    A large meta-analysis of 123 studies with over 600,000 participants examining the effect of blood pressure reduction on cardiovascular outcomes.

    Every 10 mmHg reduction in systolic blood pressure reduced stroke risk by 27%, heart disease by 17% and all-cause mortality by 13%.

    The role of cholesterol in cardiovascular risk

    LDL cholesterol ("bad cholesterol") directly contributes to plaque build-up in blood vessels. The longer vessels are exposed to high levels, the greater the cumulative damage. Early detection and treatment of elevated cholesterol is therefore crucial.

    Statins are the cornerstone of cholesterol-lowering treatment and have been studied in some of the largest and most well-known clinical trials in cardiology.

    30%

    reduction in total mortality with statin therapy (4S)

    22%

    reduced risk of vascular events per 1 mmol/L LDL reduction (CTT)

    1 mmol/L

    LDL reduction is enough to significantly lower risk

    Key cholesterol studies

    These studies have shaped our understanding of the importance of cholesterol treatment in preventing cardiovascular disease.

    4S

    1994 · n = 4 444

    Investigated the effect of simvastatin in patients with known coronary heart disease and elevated cholesterol. A landmark study showing that cholesterol lowering saves lives.

    30% reduction in total mortality, 42% reduction in coronary death and 34% reduction in major coronary events.

    JUPITER

    2008 · n = 17 802

    Studied rosuvastatin in healthy individuals with normal LDL cholesterol but elevated CRP (inflammatory marker). Showed that statin therapy can be valuable even with normal cholesterol levels.

    44% reduction in major cardiovascular events, 48% reduction in stroke and 20% reduction in total mortality.

    CTT

    2010 · n = 170 000+

    A large meta-analysis of 26 statin trials with over 170,000 participants quantifying the benefit of LDL reduction.

    Each 1 mmol/L reduction in LDL cholesterol reduced the risk of major vascular events by 22% and total mortality by 10%.

    IMPROVE-IT

    2015 · n = 18 144

    Showed that adding ezetimibe to statin therapy provided additional LDL reduction and clinical benefit in patients after acute coronary syndrome.

    6.4% relative risk reduction in cardiovascular events, confirming the principle 'lower LDL is better'.

    Weight loss and GLP-1/GIP analogues

    Overweight and obesity increase the risk of cardiovascular disease, type 2 diabetes, hypertension and dyslipidaemia. GLP-1-based medications work by reducing appetite, increasing satiety and improving metabolic risk factors such as blood sugar, blood pressure and lipids.

    Recent clinical trials have demonstrated that these medications not only help patients lose weight but also reduce the risk of serious cardiovascular events – both in patients with established cardiovascular disease and in those without a prior diagnosis. In SURMOUNT-1, 78% of participants achieved ≥10% weight loss with tirzepatide at the highest dose (15 mg) after 72 weeks.

    22,5%

    maximum mean weight loss with tirzepatide (SURMOUNT-1)

    20%

    reduced cardiovascular risk with semaglutide (SELECT)

    13%

    reduced MACE risk with liraglutide (LEADER)

    78%

    of patients achieved ≥10% weight loss with tirzepatide

    Key studies on GLP-1/GIP and weight loss

    These studies demonstrate the strong evidence for GLP-1 and GIP-based treatment in obesity and cardiovascular prevention.

    SELECT

    2023 · n = 17 604

    Investigated semaglutide 2.4 mg in overweight/obese patients (BMI ≥27) with established cardiovascular disease but without diabetes. The first study to show cardiovascular benefit from weight loss treatment.

    20% reduction in major adverse cardiovascular events (MACE). Mean weight loss 9.4%. Significant reduction in risk of heart attack, stroke and cardiovascular death.

    STEP 1

    2021 · n = 1 961

    Studied semaglutide 2.4 mg in adults with obesity or overweight (BMI ≥30 or ≥27 with at least one weight-related complication) without diabetes.

    14.9% mean weight loss after 68 weeks compared to 2.4% in the placebo group. Improved cardiometabolic risk factors including blood pressure and lipid levels.

    SURMOUNT-1

    2022 · n = 2 539

    Investigated tirzepatide (dual GLP-1/GIP agonist) in adults with obesity or overweight without diabetes. The most potent weight loss ever shown in a phase 3 trial.

    Up to 22.5% mean weight loss at the highest dose (15 mg) after 72 weeks – 78% of participants achieved ≥10% weight loss. Significant improvements in blood pressure, lipids and waist circumference.

    LEADER

    2016 · n = 9 340

    Evaluated liraglutide in patients with type 2 diabetes and high cardiovascular risk. A landmark study showing that GLP-1 agonists can reduce cardiovascular disease.

    13% reduction in major adverse cardiovascular events, 22% reduction in cardiovascular mortality and 15% reduction in all-cause mortality.

    Conclusion: treatment pays off

    The evidence is clear – actively treating elevated blood pressure, cholesterol and overweight saves lives. GLP-1 and GIP-based medications now offer powerful weight loss with documented cardiovascular benefits. The earlier treatment is initiated, the greater the cumulative benefit.

    At Modulate, we work evidence-based and offer continuous monitoring of your blood pressure, cholesterol and weight with personalised treatment plans and regular contact with your doctor – all to give you the best possible protection against cardiovascular disease.

    Verkliga resultat

    Modulate ger hållbar viktminskning med data som bevisar det

    15–0%

    genomsnittlig viktminskning med moderna GLP-1-läkemedel

    0%

    av patienterna avslutar behandlingen inom 12 månader efter uppnådd målvikt

    0%

    förbättrad metabol hälsa under behandlingen

    0%

    minskad risk för kardiovaskulära händelser (SELECT-studien)

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