Blood pressure, stroke, and coronary heart disease
作者： R Collins , R Peto , S MacMahon , J Godwin , N Qizilbash
DOI: 10.1016/0140-6736(90)90944-Z
关键词:
摘要: There are 14 unconfounded randomised trials of antihypertensive drugs (chiefly diuretics or beta-blockers): total 37,000 individuals, mean treatment duration 5 years, diastolic blood pressure (DBP) difference 5-6 mm Hg. In prospective observational studies, a long-term Hg in usual DBP is associated with about 35-40% less stroke and 20-25% coronary heart disease (CHD). For those dying the trials, had persisted only 2-3 yet an overview showed that vascular mortality was significantly reduced (2p than 0.0002); non-vascular appeared unchanged. Stroke by 42% SD 6 (95% confidence interval 35-50%; 289 vs 484 events, 2p 0.0001), suggesting virtually all epidemiologically expected reduction appears rapidly. CHD 14% CI 4-22%; 671 771 0.01), just over half Although this significant could well be worthwhile, its size remains indefinite for most circumstances (though beta-blockers after myocardial infarction substantial benefit). At present, therefore, sufficiently high risk (perhaps because age, pressure, or, particular, history cerebrovascular disease) may clearest indication treatment.
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