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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.

Citation:

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.

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