Harvard Women's Health Watch

Drugs may not be best for mild high blood pressure

Blood pressure medicines can reduce the number of heart attacks, strokes, and deaths in people with moderate to severe high blood pressure, but they may not be of much use to those with milder elevations in blood pressure, according to a Cochrane review published this August. Researchers reviewed four studies that compared treatment with high blood pressure medications with no treatment in 8,912 participants with mild hypertension (systolic blood pressure of 140–159 mm Hg and/or diastolic blood pressure of 90–99 mm Hg). Over a five-year period, blood pressure medicine did not significantly reduce heart disease, heart attacks, strokes, or deaths in the treatment group. What's more, medication side effects led to a 9% withdrawal rate in one of the studies. The authors say that because the number of studies they analyzed was low and the evidence was not of very good quality, more trials need to be conducted before any real conclusions can be drawn. However, women with mildly elevated blood pressure may want to try nondrug interventions for lowering blood pressure—such as a healthy diet, exercise, and stress management—before turning to medications.

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