Should Patients with Mild Hypertension Be Treated?

[Argirios Argiriou]

January 13, 2015

Jamaluddin Moloo, MD, MPH reviewing Sundström J et al. Ann Intern Med 2014 Dec 23.

A modest reduction in blood pressure might prevent stroke or death.

Clinical trials have shown convincingly that treating patients who have stage 2 hypertension (systolic blood pressure [BP] ≥160 mm Hg or diastolic BP ≥100 mm Hg) prevents adverse cardiovascular events and deaths; whether this is true for patients with mild hypertension is less clear. In this meta-analysis, investigators in Sweden assessed data from 13 randomized trials (>15,000 patients) to determine whether pharmacologic BP reduction in patients with stage 1 hypertension (systolic BP 140–159 mm Hg or diastolic BP 90–99 mm Hg) lowered risk for adverse cardiovascular events and deaths. Trials were included if ≥80% of participants had stage 1 hypertension and no apparent cardiovascular disease.

During median follow-up of 4.5 years, average BP reduction in treated versus control patients was 3.6/2.4 mm Hg. Odds ratios indicated significant reductions in stroke (0.72), cardiovascular-related deaths (0.75), and overall deaths (0.78). Differences in adverse cardiovascular events, adverse coronary events, and heart failure did not reach statistical significance.

Comment

This meta-analysis indicates that treating patients with stage 1 hypertension lowers risk for stroke and death.


Citation(s):

    Sundström J et al. Effects of blood pressure reduction in mild hypertension: A systematic review and meta-analysis. Ann Intern Med 2014 Dec 23; [e-pub ahead of print]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

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