Published 29 September 2009, doi:10.1136/bmj.b3997
Cite this as: BMJ 2009;339:b3997

Letters

Drug prevention of hypertension

Contradicting Cochrane

The first 100% of the full text of this article appears below.

Law and colleagues’ conclusion that "drugs are offered to people of all levels of blood pressure" seems to contradict that of a more recent Cochrane review on blood pressure targets for the treatment of hypertension.1 This systematic review, which seems to consider the same data as Law and colleagues, concludes: "Treating patients to lower than standard blood pressure targets, ≤140-160/90-100 mm Hg, does not reduce mortality or morbidity. Because guidelines are recommending even lower targets for diabetes mellitus and chronic renal disease, we are currently conducting systematic reviews in those groups of patients."2

As generalists, we find these conflicting conclusions disturbing. Who is right?

Cite this as: BMJ 2009;339:b3997

Ray F O’Connor, general practitioner1, Ruth Moloney, trainee general practitioner1

1 Mid-West Specialist Training Programme in General Practice, University of Limerick, Limerick, Republic of Ireland

rocthedoc@eircom.net

Competing interests: None declared.

  1. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009;338:b1665. (19 May.)[Abstract/Free Full Text]
  2. Arguedas JA, Perez MI, Wright JM. Treatment blood pressure targets for hypertension. Cochrane Database Syst Rev 2009;(3):CD004349.

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Relevant Article

Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies
M R Law, J K Morris, and N J Wald
BMJ 2009 338: b1665. [Abstract] [Full Text] [PDF]

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