The Benefits of Detecting and Treating Mild Hypertension: What We Know, and What We Need to Learn
Authors: Jackson T. Wright
Journal: Annals of Internal Medicine (2014)

Editorials3 February 2015The Benefits of Detecting and Treating Mild Hypertension: What We Know, and What We Need to LearnJackson T. Wright Jr., MD, PhDJackson T. Wright Jr., MD, PhDFrom Case Western Reserve University, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2836 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This issue includes 2 systematic reviews dealing with the diagnosis and management of hypertension. In the first, Sundström and colleagues assess the evidence on the effects of blood pressure reduction on cardiovascular outcomes in patients with stage 1 hypertension (1). In the second, Piper and associates evaluate methods used to identify persons with elevated blood pressure (2)Sundström and colleagues combined data from a previous systematic review of 3 trials (3) with patient-level data from participants with stage 1 hypertension in the BPLTTC (Blood Pressure Lowering Treatment Trialists' Collaboration) database (4). The earlier review reported no significant reduction in cardiovascular ...References1. Sundström J, Arima H, Jackson R, Turnbull F, Rahimi K, Chalmers J, et al; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of blood pressure reduction in mild hypertension. A systematic review and meta-analysis. Ann Intern Med. 2015;162:184-91. doi:10.7326/M14-0773 LinkGoogle Scholar2. Piper MA, Evans CV, Burda BU, Margolis KL, O'Connor E, Whitlock EP. Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2015;162:192-204. doi:10.7326/M14-1539 LinkGoogle Scholar3. Diao D, Wright JM, Cundiff DK, Gueyffier F. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev. 2012;8:CD006742. [PMID: 22895954] doi:10.1002/14651858.CD006742.pub2 CrossrefMedlineGoogle Scholar4. Turnbull F; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527-35. [PMID: 14615107] CrossrefMedlineGoogle Scholar5. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ. 2009;338:b1665. [PMID: 19454737] doi:10.1136/bmj.b1665 CrossrefMedlineGoogle Scholar6. Proschan M, Ford CE, Cutler JA, Graumlich JF, Pavlik V, Cushman WC, et al; LHAT Collaborative Research Group. How much effect of different antihypertensive medications on cardiovascular outcomes is attributable to their effects on blood pressure? Stat Med. 2013;32:884-97. [PMID: 22961832] doi:10.1002/sim.5580 CrossrefMedlineGoogle Scholar7. Davis EM, Appel LJ, Wang X, Greene T, Astor BC, Rahman M, et al; African American Study of Kidney Disease and Hypertension Research Collaborative Group. Limitations of analyses based on achieved blood pressure: lessons from the African American study of kidney disease and hypertension trial. Hypertension. 2011;57:1061-8. [PMID: 21555676] doi:10.1161/HYPERTENSIONAHA.111.169367 CrossrefMedlineGoogle Scholar8. James PA, Oparil S, Carter B, Cushman WC, Himmelfarb CD, Handler J, et al. An evidence-based guideline for the management of high blood pressure in adults. JAMA. 2015. [Forthcoming] Google Scholar9. Wright JT, Fine LJ, Lackland DT, Ogedegbe G, Dennison Himmelfarb CR. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014;160:499-503. [PMID: 24424788] doi:10.7326/M13-2981 LinkGoogle Scholar10. National Institute for Health and Care Excellence. Hypertension: Clinical Management of Primary Hypertension in Adults. London: National Institute for Health and Care Excellence; 2011. Accessed at http://publications.nice.org.uk/hypertension-cg127 on 15 December 2014. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Case Western Reserve University, Cleveland, Ohio.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2836.Corresponding Author: Jackson T. Wright Jr., MD, PhD, Professor of Medicine, Program Director, William T. Dahms, MD Clinical Research Unit, Clinical and Translational Science Collaborative, Case Western Reserve University, Director, Clinical Hypertension Program, University Hospitals Case Medical Center, Bolwell Suite 2200, 11100 Euclid Avenue, Cleveland, OH 44106-6053; e-mail, Jackson.[email protected]edu.This article was published online first at www.annals.org on 23 December 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnostic and Predictive Accuracy of Blood Pressure Screening Methods With Consideration of Rescreening Intervals: A Systematic Review for the U.S. Preventive Services Task Force Margaret A. Piper , Corinne V. Evans , Brittany U. Burda , Karen L. Margolis , Elizabeth O'Connor , and Evelyn P. Whitlock Effects of Blood Pressure Reduction in Mild Hypertension Johan Sundström , Hisatomi Arima , Rod Jackson , Fiona Turnbull , Kazem Rahimi , John Chalmers , Mark Woodward , Bruce Neal , and Effects of Blood Pressure Reduction in Mild Hypertension Johan Sundström , Hisatomi Arima , Rod Jackson , Fiona Turnbull , Kazem Rahimi , John Chalmers , Mark Woodward , Bruce Neal , and Correction: The Benefits of Detecting and Treating Mild HypertensionCorrection: The Benefits of Detecting and Treating Mild Hypertension Metrics Cited byCorrection: The Benefits of Detecting and Treating Mild Hypertension 3 February 2015Volume 162, Issue 3Page: 233-234KeywordsBlood pressureCardiovascular diseasesClinical trialsDisclosureDrugsHypertensionMyocardial infarctionSystematic reviewsSystolic pressureTreatment guidelines ePublished: 3 February 2015 Issue Published: 3 February 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...