Tuesday, December 13, 2011

Hypertension: When Is Blood Pressure Too High? Part 2

Two months ago, I pointed a new study that demonstrated at pre-hypertension, that no man's land between normal blood pressure & hypertension, was associated with an increase risk of stroke.  Well, in a meta-analysis published online this week prior to print in February 2012, the authors proved that treating patients w/pre-hypertension lowered their risk of stroke.  

Specifically, in 16 studies involving 70,664 participants, those w/pre-hypertension (systolic blood pressure 120-139mm Hg and/or diastolic blood pressure 80-89mm Hg) randomized to treatment had a statistically significant 22% reduction in stroke risk compared to those randomized to placebo.  In fact, only 169 patients had to be treated for 4+ years in order to prevent 1 stroke (which compares favorably to the 118 w/hypertension who need to be treated in order to prevent 1 stroke).

As with any other therapy, there was a downside to these double-edged medications.  High potassium, kidney failure, excessively low blood pressure, and water retention were all identified as complications & side effects of the medications.  When you consider that over 53 million adults in America alone have pre-hypertension, even the small risk of side effect implies affecting a not inconsequential number of patients.  

I don't know about you, but aside from kidney failure, I'd rather deal w/hyperkalemia, hypotension, and edema than the residual effects of a stroke.



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