For low-risk patients with mild hypertension, starting antihypertensive drug treatment might not reduce mortality, according to a JAMA Internal Medicine study. The American College of Cardiology and American Heart Association currently recommend that all patients with systolic blood pressure at or above 140 mm Hg or diastolic BP at or above 90 mm Hg receive antihypertensive therapy.
In this study of electronic health records of 38 286 low-risk patients with mild hypertension, no evidence of an association was found between exposure to antihypertensive treatment and mortality or cardiovascular disease. There was evidence that treatment may be associated with an increased risk of adverse events, such as hypotension, syncope, and acute kidney injury.
The findings suggest that physicians should be cautious when initiating treatment in low-risk patients with mild hypertension, particularly because such an approach may affect millions of individuals with little evidence of benefit.
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Source: JAMA and NEJM Journal Watch
