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 .
INSIGHT: international nifedipine GITS study intervention as a goal in hypertension treatment.
The objective of the study is to compare fatal and nonfatal cardiovascular endpoints in hypertensive patients r and omised to the calcium-channel blocker , nifedipine GITS or a thiazide diuretic , co-amilozide . A total of 6592 patients from nine countries ( UK , France , Israel , Spain , Italy , The Netherl and s , Sweden , Denmark and Norway ) will be recruited , aged 55 - 80 and with a blood pressure ( BP ) > or = 150/95 or > or = 160 mm Hg ( systolic ) . All patients will have at least one other major cardiovascular risk factor . Patients will be minimised by country and risk factors and r and omised to double-blind treatment with either nifedipine GITS or diuretic . After a single dose titration , additional treatment will be atenolol or enalapril ( where beta-blockade is contra-indicated ) . After achieving a target BP of 140/90 mm Hg patients will be followed for a total of 3 years . Primary endpoints are myocardial infa rct ion , stroke , subarachnoid haemorrhage , heart failure and sudden cardiac death . The study has a power of 80 % at 5 % significance to detect a difference between 8 % event rate over 3 years in diuretic-treated patients and 6 % in those receiving nifedipine
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 .