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An Overview of the Meta-analyses of the Hypertension Treatment Trials

Marvin Moser, MD; Patricia Hebert, PhD; Charles H. Hennekens, MD
Arch Intern Med. 1991;151(7):1277-1279. doi:10.1001/archinte.1991.00400070055005.
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The recent publication of a new meta-analysis of 14 randomized trials of antihypertensive drug therapy in the Lancet has heightened the debate regarding the benefits of treatment of hypertension.1,2 There is little disagreement that pharmacologic therapy results in a decrease in strokes and in stroke deaths, reduction in the occurrence of congestive heart failure, reversal of left ventricular hypertrophy in more patients receiving treatment than on placebo or control, and a reduction in the rate of progression of renal disease in adequately treated hypertensive subjects.3-7 This article stems from the finding in the new meta-analysis that hypertension treatment results in a significant reduction in coronary heart disease (CHD). Although previous individual trials and overviews have suggested reductions of a similar magnitude, these findings have been dismissed as unimportant because statistical significance was not achieved.2 This most recent and comprehensive meta-analysis included over 37 000 patients treated for


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