Intended for healthcare professionals


Cochrane review finds no proved benefit in drug treatment for patients with mild hypertension

BMJ 2012; 345 doi: (Published 14 August 2012) Cite this as: BMJ 2012;345:e5511
  1. Jeanne Lenzer
  1. 1New York

Treating patients with stage 1 (mild) hypertension has no benefit, a Cochrane review of studies conducted in the United Kingdom, Australia, and the United States has found.1

Data from four randomised controlled trials, involving 8912 patients with stage 1 hypertension (systolic blood pressure 140-159 mm Hg or diastolic 90-99 mm Hg, or both) and treated for four to five years, found that drug treatment did not reduce total mortality (risk ratio 0.85 (95% confidence interval 0.63 to 1.15)), coronary heart disease (1.12 (0.8 to 1.57), or stroke (0.51 (0.24 to 1.08)). Patients with pre-existing cardiovascular disease were excluded from the study.

David Cundiff, one of the reviewers, said that he believes that the analysis should lead to dramatic changes in the way doctors treat mild hypertension, allowing patients to throw away their blood pressure pills and focus instead on far more effective as well as evidence based approaches, such as exercising, smoking cessation, and eating a DASH (diet against systolic hypertension) or Mediterranean diet.

Cundiff told the BMJ that “in light of the negative results of the trials in the literature” further clinical …

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