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Early initiation of hypertensives ‘reduces mortality’



By Christian Duffin

Early initiation of hypertension treatment is associated with a significant survival benefit, a meta-analysis has shown.

US researchers conducted a two-phase meta-analysis of 18 trials of more than 130,000 patients.

In the first phase, lasting 30 months, half of patients received active therapy – an ACE inhibitor, diuretic or beta blocker – while the other half took a placebo. In the second, lasting an average of 41 months, all patients had active therapy.

Median rates of antihypertensive medication use were similar in both groups, at 59% of those initially on active therapy and 43% of those on placebo. But patients who received active treatment in the first phase as well as the second had a 15% lower mortality risk than those who had taken placebo initially before starting active therapy.

Study leader Dr William Kostis, a research fellow in medicine at Massachusetts General Hospital in Boston, suggested this difference may be the result of ‘prevention or regression of pathological and functional changes caused by hypertension.’

He concluded: ‘The data imply that earlier initiation of antihypertensive therapy will result in significant clinical benefits.’

Hypertension 2011; 56: 1060-1068

Early initiation of hypertensives ‘reduces mortality’