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No benefit from blood pressure treatment in patients with mild hypertension

Antihypertensive medication for patients with mildly elevated blood pressure is no better at preventing cardiovascular events than placebo, according to a systematic review of the latest evidence.

The analysis from the Cochrane Collaboration looked at four trials totalling 8,912 patients aged 18 or older with mild hypertension and no history of cardiovascular disease. Mild hypertension was defined as systolic blood pressure of 140-159mmHg and/or diastolic blood pressure of 90-99mmHg.

After four to five years, antihypertensive treatment did not significantly reduce total mortality compared with placebo, despite a risk ratio reduction of 0.85. Nor did it significantly reduce the risk of stroke (risk ratio of 0.51) or total cardiovascular events (risk ratio reduction of 0.97) compared with placebo.

But there was a fivefold increase in withdrawals in the trials due to adverse events in the antihypertensive-treated group, compared with placebo, with a 9% discontinuation rate due to adverse effects.

The Canadian and French researchers concluded: ‘Based on the best available evidence, this review does not show any significant benefit of antihypertensive drug therapy in reducing morality, heart attacks, strokes or overall cardiovascular events.'

Cochrane Collaboration 2012, online 15 August