Antihypertensives Beneficial in Absence of Hypertension

In patients with cardiovascular disease, antihypertension drugs tied to lower morbidity

TUESDAY, March 1 (HealthDay News) -- Patients with a clinical history of cardiovascular disease (CVD), but without hypertension, may benefit from antihypertensive treatment to reduce CVD morbidity and mortality, according to a literature review published in the March 2 issue of the Journal of the American Medical Association.

Angela M. Thompson, M.S.P.H., of the Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues conducted a meta-analysis to determine how antihypertensive treatment affects secondary prevention of CVD events and all-cause mortality. They examined 25 randomized clinical trials that included a range of patients with a history of CVD or diabetes mellitus but without defined hypertension who received treatment with various antihypertensive medications. Outcomes included stroke, myocardial infarction (MI), congestive heart failure (CHF), composite CVD outcomes, CVD mortality, and all-cause mortality.

The researchers found that participants receiving antihypertensive treatment were at significantly less pooled relative risk of CVD outcomes, including stroke, MI, CHF, composite CVD events, CVD mortality, and all-cause mortality. The absolute risk reduction per 1,000 persons was −7.7 for stroke, −13.3 for MI, −43.6 for CHF, −27.1 for composite CVD events, −15.4 for CVD mortality, and −13.7 for all-cause mortality. These associations were consistent across all the trial groups and clinical history subgroups.

"Our results show that persons with a history of CVD but with blood pressures in the normal and prehypertensive ranges can obtain significant benefit from antihypertensive treatments," the authors write. "Additional randomized trial data are necessary to assess these outcomes in patients without CVD clinical recommendations."

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