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 .
Statistical considerations in monitoring the Systolic Hypertension in the Elderly Program (SHEP).
The Systolic Hypertension in the Elderly Program ( SHEP ) , a r and omized , double-masked , placebo-controlled trial of 4736 persons , was design ed to assess the efficacy of antihypertensive drug treatment to reduce the risk of fatal and nonfatal strokes among people age 60 and over with isolated systolic hypertension . The statistical method used in interim monitoring of results was conditional power ( or stochastic curtailment ) . The findings did not become conclusive until near the completion of the trial , and therefore SHEP was continued to its scheduled closing date . The trial demonstrated a 36 % reduction in the incidence of stroke in the active treatment group ( P = .0003 ) . In addition to evaluating overall efficacy of treatment , the monitoring process considered such other issues as nonstroke outcomes , lag time between first report of stroke and final confirmation of stroke diagnosis , consistency of results across subgroups , and completeness of follow-up . The purpose of this article is to review these factors with primary emphasis on the statistical aspects
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 .