Table 7, Clinical evidence summary: Treatment versus no treatment at systolic blood pressure threshold of 140–159mmHg at low cardiovascular risk (without type 2 diabetes) – non-randomised evidence - Evidence review for initiating treatment

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Table 7Clinical evidence summary: Treatment versus no treatment at systolic blood pressure threshold of 140–159mmHg at low cardiovascular risk (without type 2 diabetes) – non-randomised evidence

Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects³
Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Risk with No treatment (no diabetes)	Risk difference with Treatment (95% CI)
Mortality 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW² due to indirectness	HR 1.02 (0.88 to 1.18)⁴	41 per 1,000	1 more per 1,000 (from 5 fewer to 7 more)
Stroke 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW¹^,² due to, imprecision, indirectness	HR 0.97 (0.78 to 1.21)⁴	15 per 1,000	0 fewer per 1,000 (from 3 fewer to 3 more)
Myocardial Infarction 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW² due to indirectness	HR 1.00 (0.80 to 1.25)⁴	15 per 1,000	0 fewer per 1,000 (from 3 fewer to 4 more)
Heart failure 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW¹^,² due to imprecision, indirectness	HR 1.34 (0.96 to 1.87)⁴	7 per 1,000	2 more per 1,000 (from 0 fewer to 6 more)
Non-MI acute coronary syndrome 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW¹^,² due to imprecision, indirectness	HR 1.19 (0.74 to 1.91)⁴	3 per 1,000	1 more per 1,000 (from 1 fewer to 3 more)
Hypotension 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW² due to indirectness	HR 1.69 (1.30 to 2.20)⁴	8 per 1,000	6 more per 1,000 (from 3 more to 10 more)
Acute Kidney Injury 140–159 mmHg	38,286 (1 study) 5.8 years	VERY LOW¹^,² due to imprecision, indirectness	HR 1.37 (1 to 1.88)⁴	8 per 1,000	3 more per 1,000 (from 0 more to 7 more)

1: Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs.
2: Downgraded by 1 or 2 increments because the majority of the evidence included an indirect or very indirect population respectively.
3: Absolute effects calculated by inputting raw event data from median follow up time into GRADE.
4: Evidence based on one study that reported HRs with raw event data.

From: Evidence review for initiating treatment

Cover of Evidence review for initiating treatment

Evidence review for initiating treatment: Hypertension in adults: diagnosis and management: Evidence review C.

NICE Guideline, No. 136.

National Guideline Centre (UK).

London: National Institute for Health and Care Excellence (NICE); 2019 Aug.

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