In severe and accelerated hypertension the benefits of treatment are c
learcut. In patients <60 years of age with mild hypertension the main
benefit is reduction of stroke by about 40%. The death rate from strok
e is declining in many affluent countries for reasons which can only b
e partly explained by mass treatment of hypertension. In the MRC trial
in patients (60 years old it took 2500 patient/years of treatment to
save one stroke. If the number of strokes is declining for other reaso
ns the number of patient/years to save one stroke may be increasing. I
n older patients the absolute benefit is greater because they suffer m
ore stroke events and because treatment also reduces coronary events.