Cardiovascular benefits of antihypertensive therapy
THE CONTEXT
Antihypertensive treatment aims to prevent adverse cardiovascular events, particularly coronary artery disease, stroke and heart failure.
Relative and absolute benefits
•
Randomised controlled trials show a reduction in stroke and, to a lesser extent, coronary artery disease.
•
The approximate relative risk reductions are 30% for stroke and 20% for coronary artery disease.
•
Relative benefits are similar across patient groups, so the absolute benefit—the total number of events prevented—is greatest in those at highest risk.
Trial illustration
•
Extrapolation from the Medical Research Council Mild Hypertension Trial indicates that 566 young patients would need bendroflumethiazide treatment for one year to prevent one stroke.
•
In the Medical Research Council trial in older adults, one stroke was prevented for every 286 patients treated for one year.