Do not treat mild hypertension with low risk for heart disease

The benefit from antihypertensive therapy is unproven in patients with mild hypertension and no preexisting cardiovascular disease. 

A meta-analysis combined four placebo-controlled trials adding together 8912 patients with mild hypertension and no preexisting cardiovascular disease.

Up to 5 years of follow-up, antihypertensive therapy resulted in lower rates of mortality and stroke but higher rates of heart attacks.

Low-risk patients with mild hypertension and no preexisting cardiovascular disease who fail to reduce their blood pressure with lifestyle modification should receive antihypertensive therapy.