The key quotation: “No trials have examined primary prevention of cardiovascular disease events among patients exclusively with mild hypertension. Given that thousands of patients would need to be followed for many years to accrue enough events to draw conclusions about mortality, it is unlikely that a placebo controlled trial assessing treatment of mild hypertension will ever be done.
Given the relatively low risk of a cardiovascular disease event among patients with mild hypertension, trials with large sample sizes and long study durations are needed. Such trials have not been done. The benefits of blood pressure reduction in people with mild hypertension, especially those with low overall cardiovascular disease risk, are therefore not clear. This lack of clarity is problematic given that about half of the people treated with antihypertensive drugs are considered to have mild hypertension.“