Treating Mild High Blood Pressure Could Save Lives

High blood pressure treatment with medication tied to lower rate of stroke and death in grade 1 hypertension

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Diet and exercise are key to controlling mild high blood pressure. But a new review suggests that another method of blood pressure control could also potentially save lives.

The researchers found that treating mild high blood pressure with prescription medication reduced the risk of stroke and death. 

Blood pressure is a measurement of how forcefully blood pushes on the arteries' walls. High blood pressure, or hypertension, has been linked to issues like heart disease, stroke and heart failure.

"High blood pressure is the most important risk factor for premature death globally," reported the authors of this new report, which was led by Johan Sundström, MD, PhD of the Uppsala Clinical Research Center at Uppsala University in Sweden. However, Dr. Sundström and team also reported that many people have grade 1 or mild high blood pressure, and the benefit of treating these patients has remained unclear.

Grade 1 blood pressure, or blood pressure that is high but only mildly so, is considered a systolic blood pressure (pressure when the heart contracts) of 140 to 159 millimeters of mercury (mm Hg) and/or diastolic blood pressure (pressure when the heart relaxes between beats) of 90 to 99 mm Hg.

To better explore the topic, the researchers performed a review of several studies, focusing on 15,266 patients with grade 1 hypertension and no history of heart disease. The average age of the patients in the studies ranged from 53.6 to 65.9.

Most of these patients (14,457) were involved in studies comparing the use of intensive antihypertension medication for high blood pressure versus placebos, or inactive medication replacements. The remaining 809 patients were involved in studies comparing the intensive medications with less intensive medications.

Overall, the intensive treatment patients saw an average drop in systolic blood pressure of 3.6 mm Hg and an average drop in diastolic blood pressure of 2.4 mm Hg.

Over follow-up periods that lasted, on average, between 4 and 5 years, Dr. Sundström and team found that those on intensive high blood pressure medications had a reduced risk of several major health events.

These patients had a 28 percent reduced risk of stroke, a 25 percent reduced risk of cardiovascular death and a 22 percent reduced risk of any death.

The researchers stressed that the overall reduction in blood pressure was low, and that further research is needed to explore the potential benefits and risks of treating mild high blood pressure with medication.

In an editorial accompanying the review, Jackson T. Wright Jr., MD, PhD, of Case Western Reserve University in Cleveland, Ohio, also stressed the need for further research focusing specifically on mild high blood pressure. However, Dr. Wright also highlighted the importance of the findings.

"The fact that modest blood pressure reduction in this younger population without clinical cardiovascular disease significantly reduces hard clinical outcomes, such as stroke and death, shows promise for even greater absolute event reduction in higher-risk populations, such as older persons, those with cardiovascular disease, and high-risk racial or ethnic subgroups," Dr. Wright wrote.

This review and editorial were published December 22 in Annals of Internal Medicine.

Funding for the review was provided by a number of organizations, including the Swedish Heart-Lung Foundation and the Australian Research Council. The study authors reported that these groups had no role in the design or analysis of the study.

Review Date: 
December 21, 2014
Last Updated:
December 31, 2014