Antihypertensive drugs used to treat predominantly healthy adults aged 18 to 59 years with mild to moderate primary hypertension have a small absolute effect to reduce cardiovascular mortality and morbidity primarily due to reduction in cerebrovascular mortality and morbidity .
All-cause mortality and coronary heart disease were not reduced .
There is lack of good evidence on withdrawal due to adverse events .
BACKGROUND Hypertension is an important risk factor for adverse cardiovascular events including stroke , myocardial infa rct ion , heart failure and renal failure .
The main goal of treatment is to reduce these events .
Systematic review s have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older .
We wanted to know what the effects of therapy are in people 18 to 59 years of age .
OBJECTIVES To quantify antihypertensive drug effects on all-cause mortality in adults aged 18 to 59 years with mild to moderate primary hypertension .
To quantify effects on cardiovascular mortality plus morbidity ( including cerebrovascular and coronary heart disease mortality plus morbidity ) , withdrawal due adverse events and estimate magnitude of systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) lowering at one year .
RETRACTED: Valsartan in a Japanese population with hypertension and other cardiovascular disease (Jikei Heart Study): a randomised, open-label, blinded endpoint morbidity-mortality study
BACKGROUND Drugs that inhibit the renin-angiotensin-aldosterone system benefit patients at risk for or with existing cardiovascular disease . However , evidence for this effect in Asian population s is scarce . We aim ed to investigate whether addition of an angiotensin receptor blocker , valsartan , to conventional cardiovascular treatment was effective in Japanese patients with cardiovascular disease . METHODS We initiated a multicentre , prospect i ve , r and omised controlled trial of 3081 Japanese patients , aged 20 - 79 years , ( mean 65 [ SD 10 ] years ) who were undergoing conventional treatment for hypertension , coronary heart disease , heart failure , or a combination of these disorders . In addition to conventional treatment , patients were assigned either to valsartan ( 40 - 160 mg per day ) or to other treatment without angiotensin receptor blockers . Our primary endpoint was a composite of cardiovascular morbidity and mortality . Analysis was by intention to treat . The study was registered at clintrials.gov with the identifier NCT00133328 . FINDINGS After a median follow-up of 3.1 years ( range 1 - 3.9 ) the primary endpoint was recorded in fewer individuals given valsartan than in controls ( 92 vs 149 ; absolute risk 21.3 vs 34.5 per 1000 patient years ; hazard ratio 0.61 , 95 % CI 0.47 - 0.79 , p=0.0002 ) . This difference was mainly attributable to fewer incidences of stroke and transient ischaemic attack ( 29 vs 48 ; 0.60 , 0.38 - 0.95 , p=0.028 ) , angina pectoris ( 19 vs 53 ; 0.35 , 0.20 - 0.58 , p<0.0001 ) , and heart failure ( 19 vs 36 ; 0.53 , 0.31 - 0.94 , p=0.029 ) in those given valsartan than in the control group . Mortality or tolerability did not differ between groups . INTERPRETATION The addition of valsartan to conventional treatment prevented more cardiovascular events than supplementary conventional treatment . These benefits can not be entirely explained by a difference in blood pressure control
Antihypertensive drugs used to treat predominantly healthy adults aged 18 to 59 years with mild to moderate primary hypertension have a small absolute effect to reduce cardiovascular mortality and morbidity primarily due to reduction in cerebrovascular mortality and morbidity .
All-cause mortality and coronary heart disease were not reduced .
There is lack of good evidence on withdrawal due to adverse events .
BACKGROUND Hypertension is an important risk factor for adverse cardiovascular events including stroke , myocardial infa rct ion , heart failure and renal failure .
The main goal of treatment is to reduce these events .
Systematic review s have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older .
We wanted to know what the effects of therapy are in people 18 to 59 years of age .
OBJECTIVES To quantify antihypertensive drug effects on all-cause mortality in adults aged 18 to 59 years with mild to moderate primary hypertension .
To quantify effects on cardiovascular mortality plus morbidity ( including cerebrovascular and coronary heart disease mortality plus morbidity ) , withdrawal due adverse events and estimate magnitude of systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) lowering at one year .