antihypertensive therapy may not always reduce mortality

Antibypertemive therapy may not always reduce DlOI1aIity THERAPY Antihypertensive therapy increased life expectancy in patients with hi gh pretreatment mortality risks, but may have reduced ti fe expectancy in patients with lower mon.ality risks before treatment. This is according to the results of a meta-analysis conducted by researchers in The Netherlands. Seven controlled trials comprising a total of 34 342 previously untreated patients < 60 years of age with mild to moderate hypertension (diastolic BP 90-114mm Hg) were included in the meta-analysis. A total of 17 185 patients received antihypertensive treatment (bendroflumethiazide, chlorothiazide, chlorthalidone, hydralazine, hydrochlorothiazide or propranolol) and 17 157 patients were controls. 'All cause' mortality rates and incidence of fatal coronary heart disease (ClID) and stroke were expressed as deaths per 1000 patient-years of follow-up. Overall, 564 treated patients and 628 control patients died during follow-up. In trials with an overall mortality rate of> 6 per 1000 years of follow-up in their control groups, antihypertensive treatment increased life expectancy. However, antihypertensive therapy had no effect on, or even reduced survival rates in trials whose control groups had an overall mortality rate of < 6 per 1000 follow-up years. The results were similar with regard to CHD mortality. Antihyperten si ve therapy reduced the incidence of stroke regardless of control group mortality rates. Hoc$ AW, Grobbcc DE, L.ut.co J. dnI, Unprov' survival? Rco:oDCilina; !be IriaII In mild·to-modcnIe bypo::neru.ion. Journal of Hypenension 13: 8QS·811.JullWS -" 15

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Antibypertemive therapy may not always reduce DlOI1aIity

THERAPY

Antihypertensive therapy increased life expectancy in patients with high pretreatment morta lity risks, but may have reduced ti fe expectancy in patients with lower mon.ality risks before treatment. This is according to the results of a meta-analysis conducted by researchers in The Netherlands.

Seven controlled trials comprising a total of 34 342 previously untreated patients < 60 years of age with mild to moderate hypertension (diastolic BP 90-114mm Hg) were included in the meta-analysis. A total of 17 185 patients received antihypertensive treatment (bendroflumethiazide, chlorothiazide, chlorthalidone, hydralazine, hydrochlorothiazide or propranolol) and 17 157 patients were controls. 'All cause' mortality rates and incidence of fatal coronary heart disease (ClID) and stroke were expressed as deaths per 1000 patient-years of follow-up.

Overall, 564 treated patients and 628 control patients died during follow-up. In trials with an overall mortality rate of> 6 per 1000 years of follow-up in their control groups, antihypertensive treatment increased life expectancy.

However, antihypertensive therapy had no effect on, or even reduced survival rates in trials whose control groups had an overall mortality rate of < 6 per 1000 follow-up years. The results were similar with regard to CHD mortality.

Antihypertensive therapy reduced the incidence of stroke regardless of control group mortality rates. Hoc$ AW, Grobbcc DE, L.ut.co J. ~ dnI, ~ Unprov' survival? Rco:oDCilina; !be IriaII In mild· to-modcnIe bypo::neru.ion. Journal of Hypenension 13: 8QS·811.JullWS

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