The benefits and risks of treating mild to moderate hypertension

The risks and benefits of treating mild to moderate hypertension (defined as a diastolic blood pressure level between 90-114 mm Hg) were quantified in order to assist clinical decision making. Presenting such information ought to be an essential part of the process of obtaining the patient's consent for treatment. Using estimates from clinical trials that antihypertensive drug therapy reduces all-cause mortality by 11% and stroke incidence by 39%, the benefits of treatment--expressed as the average number of people needing to be treated annually in order to prevent one death--ranges from 333 to 3393 in men, and from 508 to 5094 in women. The average number of people needing to be treated annually to prevent one stroke ranges from 281 to 4292 in men, and from 253 to 13,477 in women. The benefits of treatment are greatest in men, in the older age groups, and at higher diastolic blood pressure levels. Compared to the benefits, the annual risk of developing a side effect of the medication is much higher.