Document Detail


The effects of antihypertensive drug treatment on the incidence of stroke and of coronary heart disease.
MedLine Citation:
PMID:  2676257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of differences in usual diastolic blood pressure (DBP) on the risks of stroke and of coronary heart disease (CHD) were estimated from nine major prospective observational studies involving about 420,000 men and women, followed up over intervals of 6 to 25 years. The results indicated that a prolonged difference in usual DBP of approximately 6 mmHg was associated with about 36% (+/- 2) fewer strokes and 22% (+/- 1) fewer CHD deaths and non-fatal myocardial infarctions. The effects of equivalent reductions in DBP produced by antihypertensive drug treatment but maintained for just a few years, have been estimated in several overviews of randomised controlled trials, involving totals of between 30,000 and 40,000 hypertensive patients. The results of the overviews indicated that antihypertensive treatment reduced the risk of stroke by about 40%, suggesting that all of the long-term potential benefit for stroke of lower DBP was achieved within about 3 years of beginning treatment. The risk of CHD may have been reduced by about 10% among patients allocated active treatment, but the 95% confidence limits for the difference ranged from about zero to about 20%. Whatever the true effect of treatment on CHD, it would appear to be somewhat less than the difference in risk estimated from the prospective observational studies for a prolonged difference in DBP of the same size. This apparent shortfall may reflect chronic pathophysiological processes in the relationship between DBP and CHD, and/or possible cardiotoxic side-effects of the principal trial treatments.
Authors:
S MacMahon
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Review    
Journal Detail:
Title:  Clinical and experimental hypertension. Part A, Theory and practice     Volume:  11     ISSN:  0730-0077     ISO Abbreviation:  Clin Exp Hypertens A     Publication Date:  1989  
Date Detail:
Created Date:  1989-11-06     Completed Date:  1989-11-06     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  8207790     Medline TA:  Clin Exp Hypertens A     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  807-23     Citation Subset:  IM    
Affiliation:
Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects
Cerebrovascular Disorders / epidemiology,  etiology,  prevention & control*
Coronary Disease / epidemiology,  etiology,  prevention & control*
Female
Humans
Hypertension / complications,  drug therapy,  physiopathology
Male
Randomized Controlled Trials as Topic
Risk Factors
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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