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Grade 1 hypertensive patients (SBP 140 to 159 mmHg, DBP 90 to 99 mmHg) without cardiovascular disease appear to benefit slightly from antihypertensive therapy, which appears to reduce risk of stroke and death.

Comment: This systematic review is suggestive, but not conclusive. The BP reduction with treatment was very small, with the systolic blood pressure being lowered only by 3.6 mmHg compared to patients given placebo. It appears there may be an effect of antihypertensive medications that go beyond their effect on blood pressure. Without knowing the individual agents used, these possible effects are difficult to determine. Should the goal be to put people with grade 1 hypertension on antihypertensive agent, but not have a target BP? After all, this review found a systolic BP reduction of only 3.6 mmHg, making it hard to imaging that the BP reduction was the primary factor in reducing stroke and early death.



Ann Intern Med. 2014 Dec 23. doi: 10.7326/M14-0773.    (retrieved Dec, 2014). There are currently 887 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2019 by the Internet Medical Association. Click Here to view more medical pearls.