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Limited benefits from pharmacotherapy for hypertension in people aged under 60
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Limited benefits from pharmacotherapy for hypertension in people aged under 60
Compared with placebo or no treatment, how effective is pharmacotherapy for hypertension in adults aged 18 to 59 years?
Treatment had little or no effect on death from any cause compared with placebo or no treatment (2.4% with placebo/no treatment versus 2.3% with treatment; low-quality evidence), and it reduced the number of people experiencing heart disease or death from heart disease, from 4.1% to 3.2% (low-quality evidence). It reduced stroke by a small amount from 1.3% to 0.6% (low-quality evidence). There was uncertainty about the effects of treatment on the number of people who had blocked arteries (low-quality evidence). There was a lack of good evidence on withdrawal due to adverse events. The average duration of treatment was five years. Medicine classes studied in most people included thiazides and beta-blockers.
The effects of treatment on blood pressure varied between the studies, and there was uncertainty as to how much of a difference treatment made on average.
Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality, but most of the evidence is in people aged 60 and older.
Musini VM et al. Pharmacotherapy for hypertension in adults aged 18 to 59 years. Cochrane Reviews, 2017, Issue 8. Art. No.: CD008276.DOI: 10.1002/14651858. CD008276.pub2. This review contains seven studies involving 17,327 participants.