An update on the Medical Research Council Hypertension Trial.

The principal results of the Medical Research Council (MRC) Hypertension Trial were published in mid-1985 and additional papers are in preparation which will give more detailed information about important issues such as the influence of treatment upon ischaemic heart disease. This paper briefly reviews some points about the trial. The main results of the MRC trial were that stroke was reduced on average by about half (69% with bendrofluazide, 27% with propranolol); coronary events, although not reduced across the board, were reduced by one-third in male non-smokers treated with propranolol; and compared with placebo, all-cause mortality in the actively treated groups was lower in men but higher in women. The implications of these results are discussed. It is hoped that the MRC trial will open the way to a more intelligently targeted approach that may help to reduce the incidence of stroke and myocardial infarction by skillful selection of patients and drugs. By this selection, many patients who are at very low risk or for whom the risks of treatment may outweight the likely benefits will be spared the cost and inconvenience of prolonged treatment.