August 16th, 2012
Cochrane Review: Benefits of Treating Mild Hypertension Not Clear
The benefits of treating patients with mildly elevated blood pressure who are free of cardiovascular disease are unclear, according to a Cochrane review. These findings conflict with current hypertension treatment guidelines in the U.S., Canada, and Europe.
Researchers analyzed data from nearly 9000 participants in four trials and found no obvious benefit of drug treatment in patients with mild hypertension (systolic BP, 140 to 159 mm Hg and/or diastolic BP, 90 to 99 mm Hg) in terms of total mortality or cardiovascular events at 5 years’ follow-up. They did, however, see an increased likelihood of drug withdrawal due to adverse effects (relative risk, 4.8).
Now THAT’S interesting. Nice to see some support for all us dinosaurs out there who hesitate to rush, treat, titrate, and deal with side effects. Again we come full circle perhaps. Do no harm/less is more….
Why not just prescribe carbohydrate restriction to mild hypertensives? In well-counselled adherers, it can lower systolic BP by 30-40 mmHg, and does seem to be more natural than lifelong drug therapy (which, unlike carb restriction, is not known to simultaneously reduce BP, triglycerides, hsCRP, A1c, insulin levels, glucose, waist circumference, interleukin-6, etc).
30-40 mmHg? Is that really correct? Thanks
Surprising ! If, mild hypertension should not be treated, then why have a category of “Pre-Hypertension” ?