Pharmacotherapy for mild hypertension.

@article{Diao2012PharmacotherapyFM,
  title={Pharmacotherapy for mild hypertension.},
  author={Diana Y Diao and James M. Wright and David K Cundiff and François Gueyffier},
  journal={The Cochrane database of systematic reviews},
  year={2012},
  volume={8},
  pages={
          CD006742
        }
}
BACKGROUND People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomised controlled trial (RCT) evidence. OBJECTIVES PRIMARY OBJECTIVE To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP) 140… 
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98 Citations

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TLDR
Moderate-quality evidence is provided to show that antihypertensive drugs do not reduce sudden death but do reduce both non-fatal myocardial infarction and fatal myocardia, suggesting that sudden cardiac death may not be caused primarily by acute myocardials.

Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis.

TLDR
Blood pressure-lowering therapy is likely to prevent stroke and death in patients with uncomplicated grade 1 hypertension, and withdrawal from treatment due to adverse effects was more common in the active groups.

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

  • M. Tanner
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    Annals of Internal Medicine
  • 2015
TLDR
In patients with mild hypertension and no diagnosed cardiovascular disease, blood pressurelowering drugs (vs placebo or less-intensive regimens) reduce stroke and mortality.

Randomized controlled trials of blood pressure lowering in hypertension: a critical reappraisal.

TLDR
The results of these meta-analyses provide further support to current hypertension treatment guidelines by showing that BP lowering can significantly reduce major cardiovascular outcomes largely independent of the agents used, significant risk reduction is found at all hypertension grades (stages).

Waste and harm in the treatment of mild hypertension.

  • I. Heath
  • Medicine
    JAMA internal medicine
  • 2013
TLDR
The Cochrane Review concluded that antihypertensive drugs used in the treatment of otherwise healthy adults with mild hypertension have not been shown to reduce mortality or morbidity in randomized clinical trials.

Management of mild hypertension in adults

TLDR
Lifestyle modifications for reducing blood pressure are appropriate for all patients and may be recommended while delaying drug treatment for those at lower absolute levels of cardiovascular disease risk, although net benefits are greater for patients at higherabsolute levels ofCardiovascular disease risk.

Hypertension Guidelines: Is It Time to Reappraise Blood Pressure Thresholds and Targets? Position Statement of the Latin American Society of Hypertension

TLDR
The majority of questions of practical importance that doctors ask themselves every day when treating hypertension have not been approached by randomized controlled trials or have remained unanswered, and the role of overall cardiovascular risk in treatment decisions is discussed.

Drugs in the Primary and Secondary Prevention of Coronary Artery Disease

TLDR
Beta-adrenergic blockers, inhibitors of the renin–angiotensin–aldosterone system (angiotENSin-converting enzyme inhibitors [ACEI], angiotens in receptor blockers [ARBs], aldosterone inhibitors) improve survival and reduce recurrent MI in selected subgroups of myocardial infarction (MI) survivors.

Legacy effect of delayed blood pressure lowering drug treatment in middle-aged adults with mildly elevated blood pressure: systematic review and meta-analysis

TLDR
No clinically adverse ‘legacy effect’ on mortality or major CVD event from not treating middle-aged adults at a systolic BP threshold of 140 mmHg or over is shown, which may allay concerns that early treatment of elevated systol BP is necessary to prevent CVD events in primary prevention populations.

Studies of cardiovascular disease risk estimation: how, and whether, to account for the effect of drug treatment?

TLDR
The PREDICT cohort of subjects undergoing risk assessment in New Zealand primary care was studied and serum urate was convincingly associated with CVD events, suggesting that omitting drug use information is unlikely to bias models used for disease prediction.
...

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