Antihypertensive drugs used in the treatment of adults ( primary prevention ) with mild hypertension ( systolic BP 140 - 159 mmHg and /or diastolic BP 90 - 99 mmHg ) have not been shown to reduce mortality or morbidity in RCTs .
More RCTs are needed in this prevalent population to know whether the benefits of treatment exceed the harms
BACKGROUND People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population .
The benefits and harms of treating mild hypertension in primary prevention patients are not known at present .
This review examines the existing r and omised controlled trial ( RCT ) evidence .
OBJECTIVES PRIMARY OBJECTIVE To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension ( systolic blood pressure ( BP ) 140 - 159 mmHg and /or diastolic BP 90 - 99 mmHg ) and without cardiovascular disease .
Age, race, and gender variation in the utilization of coronary artery bypass surgery and angioplasty in SHEP. SHEP Cooperative Research Group. Systolic Hypertension in the Elderly Program.
OBJECTIVE To assess variability in the use of coronary artery bypass grafting ( CABG ) and percutaneous transluminal angioplasty ( PTCA ) in the Systolic Hypertension in the Elderly Program ( SHEP ) cohort with incident coronary heart disease ( CHD ) by age , sex , and race . DESIGN Retrospective analysis of a multicenter prospect i ve cohort study . SETTING Community-based ambulatory population in academic centers . PATIENTS Among 4736 subjects initially enrolled in SHEP , there were 432 incident cases of CHD , excluding those patients who experienced rapid or sudden cardiac death . MAIN OUTCOME MEASURE Incident cases of CHD who underwent CABG or PTCA .  RESULTS Of those participants > or = 60 and < 75 years of age , 7.3 % underwent PTCA , compared with 3.9 % of those > or = 75 years ( P = 0.14 ) . 15.4 % of those < 75 underwent CABG surgery  , compared with 7.8 % of those 75 and older ( P = 0.018 ) . When both of these endpoints , CABG and PTCA , were combined , 22.4 % of those < 75 underwent a procedure , while only 11.7 % of the older cohort did ( P = 0.005 ) . Twenty-six percent of men underwent either CABG or PTCA , while only 9.1 % of women did ( P < 0.001 ) . Of those < 75 years of age , 31.1 % of men and 12.3 % of women underwent CABG or PTCA ( P < 0.001 ) . In the 75 and older age category , 19.5 % of men underwent these interventions , compared with 5.9 % of women ( P = 0.005 ) . Active treatment group was significantly associated with decreased use of procedures in participants < 75 year old with CHD . Race , activity limitations , number of comorbid conditions , education level , marital status , employment status , and social support were not significantly associated with CABG or PTCA use . When the variables studied were entered into a logistic regression model , increased age and female sex remained independently associated with decreased  CABG and PTCA use . CONCLUSION In the SHEP trial older patients and women , regardless of comorbid conditions , socioeconomic status , and social support , underwent less intensive cardiovascular interventions than did younger patients and men when they developed CHD
Antihypertensive drugs used in the treatment of adults ( primary prevention ) with mild hypertension ( systolic BP 140 - 159 mmHg and /or diastolic BP 90 - 99 mmHg ) have not been shown to reduce mortality or morbidity in RCTs .
More RCTs are needed in this prevalent population to know whether the benefits of treatment exceed the harms
BACKGROUND People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population .
The benefits and harms of treating mild hypertension in primary prevention patients are not known at present .
This review examines the existing r and omised controlled trial ( RCT ) evidence .
OBJECTIVES PRIMARY OBJECTIVE To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension ( systolic blood pressure ( BP ) 140 - 159 mmHg and /or diastolic BP 90 - 99 mmHg ) and without cardiovascular disease .