Outcome Trials in the Therapeutic Management of Hypertension in East Asians

According to the most recent epidemiological data, the prevalence of hypertension ranged from about 25% in Chinese living either in the mainland or in Taiwan and Koreans, to approximately 40% in Mongolians. The control rate of hypertension was about 35% in Koreans and Japanese, 24% in Mongolians, and less than 10% in Chinese. Four placebo-controlled trials in China unequivocally proved that antihypertensive therapy may prevent stroke and other cardiovascular complications in hypertension or patients with a history of stroke or transient ischemic attack. Four actively-controlled trials in Japan did not show significant difference between various classes or combinations of antihypertensive drugs. Two trials that compared intensive with less intensive blood pressure control in elderly Japanese hypertensive patients did not show further benefit of controlling systolic blood pressure to a level below 140 mmHg in comparison with blood pressure control to a level of 140 mmHg or above. These trials that compared various classes of antihypertensive drugs or intensive with less intensive blood pressure control often had small sample size and hence inadequate power to detect modest or moderate benefit. There is still a need for high quality outcome trial data in East Asians.