Diakonissehusets sykelius (Lorisenberg), Oslo, Norway
S U M M A R YI . The treatment of high blood pressure with modern drugs seems to improve the prospect of life for all grades of essential hypertension.2. The fatal complications are more seldom cerebral and more often cardiovascular. Especially in men coronary artery disease seems difficult to prevent.3. Most remarkable is the great percentage of surviving and symptom-free men and women, especially patients belonging to stage 2 and 3 at registration.4. Blood pressure reduction therapy seems to reduce the frequency of death directly related to hypertension. The grade of arteriosclerosis does not seem to be influenced to the same degree.Until recently there have been conflicting opinions regarding the value of antihypertensive therapy in improving the prognosis of hypertension and its complications (Goldring, 1969).
P A T I E N T S A N D M E T H O D SSince 1955 we have registered patients suffering from essential hypertension. The first part of our material consists of 225 men and 208 women registered from 1955 to 1966, and treated medically since registration.The initial assessment was made by one of us (H.S.-M.) who has also undertaken most of the follow-up examinations.The usual clinical investigations were done, including ophthalmoscopy, electrocardiogram, X-ray of chest and urography, estimations of serum potassium, serum cholesterol, serum creatinine, serum uric acid, blood sugar, and urinalysis. Blood pressure was always measured several times in the sitting and standing positions and after five kneebendings. The treatment Correspondence: Dr H. Storm-Mathisen, Diakonissehusets sykehus (Lovisenberg), Lovisenberggt 17, Oslo 4, Norway.
Abstract. Since 1955 we have registered patients suffering from essential hypertension. 433 cases, 225 men and 208 women, were graded according to WHO and Hammarström and Bechgaard's system. Medical treatment was started and followed up by one of us (HSM). The numbers of deaths in the treated sample and in an “untreated” series of 290 hypertensive patients are compared with the death rate in the corresponding general population in Norway. The same persons have made the classification of the treated and “untreated” samples.
In the treated series the numbers of deaths were 56 men and 29 women instead of the 15.61 men and 12.73 women expected, which shows a death rate of 359% for men and 228% for women. This is far better than of the “untreated” sample, in which the death rates were found to be 985% for men and 813% for women. It seems as if we have succeeded in reducing the death rate to about half by means of medical treatment. There is an appreciable reduction in the number of cerebral deaths in men in the treated sample as compared to the “untreated”. There is not a similar drop in cardiovascular deaths.
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