Hypertension and cardiovascular disease risk: what is the right anti-hypertensive strategy?

This study investigated the risk of cardiovascular events in patients taking medication for hypertension.

They found that the rate of cardiovascular events was higher in patients that are taking recommended medication.

Managing hypertension (high blood pressure) is important to prevent complications. Stroke and heart attack are some of the cardiovascular disease (CVD) events that can occur if hypertension is not treated. Treatment varies depending on a number of factors. Some patients will be told by their doctor to exercise more and eat a healthier diet. Other patients may need to take medication to reduce blood pressure (BP). These drugs are called anti-hypertensives.

The American College of Cardiology (ACC) and American Heart Association (AHA) review the treatment of hypertension. All patients with BP higher than 140/90 mmHg should be prescribed anti-hypertensives. Patients with BP 130-139/80-89 mmHg should adjust their lifestyle. Anti-hypertensives should only be prescribed if these patients have an increased risk of CVD events. The rate of CVD risk in patients with hypertension is not clear. 

This study included 29,218 patients with hypertension. 48% of patients were taking anti-hypertensive drugs. The authors analyzed BP readings at the beginning and end of the trial (maximum 4 years). Patients were contacted every 6 months and asked a number of questions about their treatment and daily life. The authors of this study analyzed information on anti-hypertensive treatment and CVD events. Patients that were recommended to take anti-hypertensives were compared to patients that were not. 

Patients that were recommended to take anti-hypertensives with a BP of 130-139/80-89 mmHg had a 6-fold higher risk of CVD events. CVD and death risks were greater in patients that were recommended to intensify their anti-hypertensive medications. 

This study concluded that the rate of cardiovascular events was higher in patients that are taking recommended medication.

Patients in this study were under the age of 45. The results may not extend to older people with hypertension. 

If you have any concerns regarding BP management please consult with your physician.