Should Patients with Mild Hypertension Be Treated?

Clinical trials have shown convincingly that treating patients who have stage 2 hypertension (systolic blood pressure [BP] ≥160 mm Hg or diastolic BP ≥100 mm Hg) prevents adverse cardiovascular events and deaths; whether this is true for patients with mild hypertension is less clear. In this meta-analysis, investigators in Sweden assessed data from 13 randomized trials (>15,000 patients) to determine whether pharmacologic BP reduction in patients with stage 1 hypertension (systolic BP 140–159 mm Hg or diastolic BP 90–99 mm Hg) lowered risk for adverse cardiovascular events and deaths. Trials were included if ≥80% of participants had stage 1 hypertension and no apparent cardiovascular disease.

During median follow-up of 4.5 years, average BP …