Patients with mild hypertension receive no benefit in terms of lowering the risk of death or cardiovascular disease from taking high blood pressure medication, though they have a higher risk of adverse events.
That’s the conclusion of a new study of more than 38,000 patients with low-risk, mild hypertension (blood pressure of 140-159/90-99 mm Hg untreated by medication). And it’s significant considering that last year, the American Heart Association and the American College of Cardiology issued a joint recommendation that blood pressure drugs be started in patients with a reading of 130/80 mm Hg or higher. Before, the recommendation threshold was 140/90.
Researchers conducted an observational study, looking at the 38,000 patients over 15 years. At the outset, none of them were receiving hypertension medications. They then compared those who were eventually treated with drugs to those who never received any treatment. Those who took a high blood pressure medication did not have a lower risk of heart attack or stroke compared to those who didn’t receive any treatment, the researchers reported in JAMA Internal Medicine.
However, those in the treatment group had an increased risk of hypotension (very low blood pressure), fainting and kidney damage.
The findings indicate that “doctors should be cautious when considering hypertension treatment in this group and we would therefore encourage a conversation between a patient and their doctor to decide the best way to treat the condition,” lead author James Sheppard, PhD, University of Oxford, said in a statement.
“Younger patients in particular may prefer to adopt lifestyle changes to reduce their blood pressure, rather than committing to taking antihypertensive drugs for many years.”