Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Treating Low-Risk Patients with Mild Hypertension

JAMA Intern Med; ePub 2018 Oct 29; Sheppard, et al

Initiating antihypertensive treatment in low-risk patients with mild hypertension has little or no benefit and may increase risk of adverse events, according to a new study. The longitudinal cohort study included electronic health records of 38,286 low-risk patients with mild hypertension (mean age 54.7 years, 56% women). Patients treated with an antihypertensive medication were matched 1:1 to similar untreated patients. The primary outcomes were rates of mortality, cardiovascular disease (CVD), and adverse events among those prescribed antihypertensive treatment at baseline, compared with those untreated. Researchers found:

  • During a median follow-up of 5.8 years, no evidence of an association was found between antihypertensive treatment and mortality (hazard ratio [HR], 1.02) or between antihypertensive treatment and CVD (HR, 1.09).
  • Treatment was associated with an increased risk of adverse events, including hypotension, syncope, and acute kidney injury.


Sheppard JP, Stevens S, Stevens R, et al. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension. [Published online ahead of print October 29, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4684.

This Week's Must Reads

Patient-Centered Intervention for Prostate Ca Care, J Clin Oncol; ePub 2019 Mar 12; Jayadevappa, et al

Subsequent Cancer Risk in Prostate Cancer, Lancet Oncol; ePub 2019 Mar 15; Mohamad, et al

Accuracy of 68Ga-PSMA-11 PET in Prostate Cancer, JAMA Oncol; ePub 2019 Mar 28; Fendler, et al

Low Muscle Mass in Patients with Prostate Cancer, J Urol; ePub 2019 Mar 27; Pak, Park, et al

Steroid Hormones & Progression of Prostate Cancer, Cancer Epidemiol Biomarkers Prev; ePub 2019 Mar 27; Lévesque, et al

Must Reads in Cardiology

Consumption of SSBs & Risk of Mortality, Circulation; ePub 2019 Mar 18; Malik, et al

Dietary Cholesterol or Egg Consumption & CVD, JAMA; 2019 Mar 19; Zhong, Van Horn, et al

Physical Activity & Incidence of CHD & CVD in Women, JAMA Netw Open; ePub 2019 Mar 15; LaCroix, et al

Intensive BP Control in Adults with Hypertension Who Smoke, JAMA Netw Open; ePub 2019 Mar 8; Scarpa, et al

Leisure-Time Physical Activity Across Adulthood, JAMA Netw Open; ePub 2019 Mar 8; Saint-Maurice, et al