Core tip: Recently, the top medical journal BMJ published a clinical review by Professor Anthony J Viera and associate professor Emily m Hawes from the Department of Medicine, University of North Carolina, Chapel Hill, USA, aiming to introduce the management of mild hypertension in adults in detail.
Cardiovascular disease is a common risk factor for one-third of the world's adults. Taking antihypertensive drugs can greatly reduce the risk of stroke, coronary heart disease, heart failure, and premature death. However, most clinical trials show that patients with moderate to severe hypertension, clear cardiovascular disease, or increased risk of cardiovascular disease can produce beneficial effects. However, its therapeutic effect on mild hypertension without cardiovascular disease is not clear.
Recently, BMJ, a top medical journal, published a clinical review by Professor Anthony J Viera and associate professor Emily m Hawes from the Department of medicine, University of North Carolina, Chapel Hill, USA, aiming to introduce the management of mild hypertension in adults in detail.
The article points out that the recent meta-analysis provides some insights on the management of mild hypertension in adults. From the summary data of a large number of clinical trials involving patients with mild hypertension, it shows that stroke, death, and total mortality caused by cardiovascular disease in patients with mild hypertension are significantly reduced. The meta-analysis compared lower target blood pressure, and the results also showed that the treatment of mild hypertension was beneficial, although the net benefit of antihypertensive treatment was greater for patients with a higher absolute risk of cardiovascular disease.
Before drug treatment, most patients with mild hypertension should have blood pressure monitoring outside the clinic to confirm hypertension. Lifestyle adjustment aimed at lowering blood pressure is suitable for all patients with hypertension, and it is recommended for those patients with a lower absolute risk of cardiovascular disease and delayed drug treatment.
Blood pressure control at the individual level of patients can be achieved through daily family blood pressure monitoring and low-cost antihypertensive drugs. For population-level blood pressure control, we need to improve the system-level interventions, such as mild hypertension registration, evidence-based program, drug follow-up, and performance indicators.