Benefits of Treating Mild Hypertension Not Clear Cut

MedicalResearch.com Interview with:

James Sheppard PhD Population Health Scientist  Nuffield Department of Primary Care Health Sciences

Dr. Sheppard

James Sheppard PhD
Population Health Scientist
Nuffield Department of Primary Care Health Sciences

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The best quality evidence for making clinical decisions comes from clinical trials. Unfortunately there are occasions where trials have not been done, or are not possible and so we rely of ‘expert opinion’ from clinical guidelines. Treatment for low risk mild hypertension is an example of this.

In our study, we looked at the medical records of more than 38,000 patients over a period of 15 years. The patients we studied were aged between 18 and 74, had mild hypertension and had not received any previous treatment. We compared patients who went on to be treated to those who were not, and found no evidence of benefit (in terms of reduced risk of heart attack or stroke), but there was an increased risk of adverse events (such as hypotension [low blood pressure], fainting or kidney damage) over the follow-up period of 5-6 years. 

MedicalResearch.com: What should readers take away from your report?

Response: The benefits of treating patients with low risk mild hypertension are not clear cut. It is possible that some patients may suffer more harm than good, so doctors should be cautious when considering treatment in this population.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: It is likely that some patients with low risk mild hypertension would benefit from treatment, whilst others would not. Future research should focus on understanding which patients have the most to gain, using the wealth of information we now collect about our patients every single day.

MedicalResearch.com: Is there anything else you would like to add?

Response: This study was not a clinical trial and therefore the results must be interpreted with caution. Observational studies such as this can sometimes give biased or unreliable results.

This work was funded by the Medical Research Council in the UK. I have no conflicts of interest to declare.

Citation: 

Shepard, J. P., Stevens, S., Stevens, R., Martin, U., Mant, J. W., Hobbs, R., & McManus, R. J. Benefits and harms of antihypertensive treatment for low risk mild hypertension: a real world, matched cohort study of over 38,000 adults. JAMA Internal Medicine https://doi.org/10.17863/CAM.27445

Nov 1, 2018 @ 12:27 pm

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