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 .
Isolated systolic hypertension: data from the European Working Party on High Blood Pressure in the Elderly.
The European Working Party on High Blood Pressure in the Elderly study ( EWPHE ) was a placebo-controlled , double-blind , inter-patient assessment of diuretic treatment in hypertensive patients aged 60 years or more . Of the 840 patients included in the study 247 had isolated systolic hypertension ( systolic blood pressure greater than or equal to 160 and diastolic blood pressure less than or equal to 95 mmHg ) . In those ( n = 120 ) r and omized to active treatment ( diazide-hydrochlorothiazide with triamterene + /- methyldopa )  blood pressure after 3 years was , on average , 19/8 mmHg lower than in the placebo group ( n = 119 ) and after 5 years the difference was 9/7 mmHg . Data on mortality and morbidity were insufficient for firm conclusions to be drawn . The data are presented here only to communicate the trends observed and to provide information that may be useful in the design of future trials . The trends observed for cardiac mortality , terminating non-fatal events ( including severe heart failure ) and combined fatal and non-fatal cardiovascular events follow a similar pattern to that observed in the trial overall , in that active treatment appeared to confer benefit . However , in the case of isolated systolic hypertension none of these differences between active and placebo treatment achieved statistical significance . We conclude that , given the epidemiological data incriminating systolic hypertension as a risk factor and the data presented here , a rigorous assessment of the value of treating isolated systolic hypertension is justified
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 .