Why the study?
Does hydrochlorothiazide-based treatment reduce mortality and cardiovascular events in symptom-free men aged 40-49 with mild hypertension?
Does hydrochlorothiazide-based treatment reduce mortality and cardiovascular events in symptom-free men aged 40-49 with mild hypertension?
In middle-aged men with mild hypertension, hydrochlorothiazide-based treatment did not reduce total or cardiovascular mortality over 5 years, though it prevented cerebrovascular events.
No mortality benefit from hydrochlorothiazide in mild hypertension; challenges broad CV risk reduction and leaves differential event effects open.
During 1972-1973, 785 symptom-free men, aged 40-49, with mild hypertension, were randomly assigned to a 5-year controlled drug treatment study, 406 in the treatment group and 379 in the control group. The basic drug was hydrochlorothiazide, in addition methyldopa or propranolol if necessary. The mean observation time was 66 months (range 60-78). At 5 years' follow-up there was no difference in total mortality between treated and controls, nor in cardiovascular mortality. There was a good prevention of cerebrovascular disease (0 vs. 7). Regarding coronary heart disease, however, there was an opposite trend (20 vs. 13, p greater than 0.10). During the trial, different drug-induced changes were observed in serum lipids, glucose and uric acid. The importance of these changes are still uncertain.
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Helgeland et al. (2008) studied this question.
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