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[Is blood pressure treatment as effective in a population setting as in controlled studies?]
H Thürmer1, P G Lund-Larsen, A Tverdal
1Statens helseundersøkelser, Oslo.
Insights
This study found that cardiovascular treatment in men aged 35-49 was associated with higher mortality. Even with lower blood pressure, treatment showed adverse effects, especially if blood pressure increased post-treatment.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Epidemiology
Background:
- Cardiovascular disease remains a leading cause of mortality globally.
- Hypertension management is crucial for cardiovascular health.
- Population-based studies are vital for understanding treatment effects in real-world settings.
Purpose of the Study:
- To investigate the impact of cardiovascular treatment on mortality in middle-aged men.
- To assess the relationship between blood pressure control and treatment outcomes.
- To identify potential adverse effects of hypertension treatment in a population cohort.
Main Methods:
- Prospective cohort study comparing treated vs. untreated men.
- Analysis of cardiovascular screening data from 21,314 men aged 35-49.
- Comparison of total and cardiovascular mortality rates between groups.
Main Results:
- A small effect of treatment on blood pressure was observed.
- Higher total and cardiovascular mortality were noted in treated men, even at lower pretreatment blood pressure.
- Adverse effects were more pronounced when blood pressure increased during treatment.
Conclusions:
- Cardiovascular treatment in this population setting showed an adverse effect on mortality.
- Treatment appears particularly detrimental at lower pretreatment blood pressure levels.
- Monitoring blood pressure changes during treatment is critical for patient outcomes.
Abstract:
Baseline (1974-76) and repeat (1977-81) cardiovascular screenings of 21,314 men aged 35-49 years brought to light 840 men who had started treatment between screenings. These were compared with men who had remained untreated. The effects of treatment on blood pressure were small, and normal target blood pressures rare. At pretreatment blood pressure up to systolic 184 mm Hg, and in most risk strata, both total mortality and cardiovascular mortality were higher among the men on treatment. This study shows an adverse effect of treatment in a population setting, particularly at low pretreatment blood pressure, and if blood pressure increases upon treatment.