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ACP Journal Club |19 May 2015

Review: In patients with mild hypertension and no CV disease, BP-lowering drugs reduce stroke and mortality

Michael Tanner, MD

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Sundström J, Arima H, Jackson R, et al; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis. Ann Intern Med. 2015;162:184-91. 25531552

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Cardiology:

In patients with mild hypertension and no cardiovascular (CV) disease, do blood pressure (BP)–lowering drugs reduce major CV events?
Included studies had duration ≥ 1 year, compared BP-lowering drugs, alone or as part of a stepped-care approach, with placebo or less-intensive BP-lowering regimens in patients ≥ 18 years of age who had mild hypertension (systolic BP 140 to 159 mm Hg or diastolic BP 90 to 99 mm Hg) and no previous CV disease; and reported ≥ 1 event for an outcome of interest. Trials were included if ≥ 80% of patients had mild hypertension {or data were available for subgroups with mild hypertension}*. Outcomes included coronary events (coronary heart disease death or nonfatal myocardial infarction), stroke (cerebrovascular death or nonfatal stroke), heart failure (resulting in hospitalization or death), CV death, all-cause mortality, and withdrawals due to adverse events.
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Tanner M. Review: In patients with mild hypertension and no CV disease, BP-lowering drugs reduce stroke and mortality. Ann Intern Med. 2015;162:JC5. doi: 10.7326/ACPJC-2015-162-10-005

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Published: Ann Intern Med. 2015;162(10):JC5.

DOI: 10.7326/ACPJC-2015-162-10-005

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