Antihypertensive drug treatment: the potential, expected and observed effects on vascular disease.
Re-analysis of the results of several prospective observational studies indicates that modest long-term differences in usual diastolic blood pressure are associated with larger differences in the primary incidence of stroke and of coronary heart disease than was previously believed. A prolonged difference of 5-6 mmHg in usual diastolic blood pressure was associated with at least one-third fewer strokes and at least one-fifth fewer coronary heart disease events. The results of randomly allocated trials of antihypertensive drug therapy (mostly diuretics) indicate that a similar difference in diastolic blood pressure maintained for just a few years appears to produce much or all of the potential long-term benefits for stroke. The incidence of coronary heart disease was also significantly reduced by treatment (2P less than 0.01). However, for coronary disease, the trial results, even in combination, are inadequate to allow a reliable determination of the size of the treatment effects and the proportion of the long-term potential benefit achieved by a few years of diuretic-based treatment.
MacMahon
S
S
Department of Medicine, University of Auckland, New Zealand.
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000517:prevention & control*; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D015994:Incidence; D015201:Meta-Analysis as Topic; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D000959:Antihypertensive Agents