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A 40 years' follow-up study of 1000 untreated hypertensive patients
Insights
This long-term study of 1038 patients with high blood pressure found that while many survived to old age, men experienced significantly higher mortality rates than women. Causes of death included stroke, heart failure, and coronary occlusion.
Area of Science:
- Cardiology
- Hypertension Research
- Longitudinal Studies
Background:
- This study examines a cohort of 1038 patients diagnosed with hypertension between 1932-1938.
- Patients had initial blood pressure readings of 160/100 mmHg or higher.
- The cohort comprised 325 men and 713 women, with an average age of 54 at initial examination.
Purpose of the Study:
- To investigate the long-term prognosis and survival rates of patients with severe hypertension.
- To analyze mortality patterns and causes of death in this hypertensive cohort.
- To compare outcomes between men and women with hypertension.
Main Methods:
- Longitudinal follow-up of 1038 hypertensive patients from 1932-1938 until 1975.
- Data collection on survival, age at death, and causes of death.
- Minimal medical intervention was provided until 1970, allowing observation of natural disease progression.
Main Results:
- 97% of patients were followed for up to 43 years, with 60 patients alive in 1975.
- 60% of men and 76% of women survived past 65 years; 9% lived beyond 85 years.
- Excess mortality was substantially higher in men compared to women.
- Leading causes of death included heart failure (24%), coronary occlusion (16%), and stroke (17%).
- Malignant hypertension was diagnosed in 13 patients initially, with no new cases recorded later.
Conclusions:
- Patients with severe hypertension exhibit variable long-term survival, with a notable proportion reaching advanced age.
- Significant sex-based differences in mortality exist, with men facing higher risks.
- Heart failure and ischemic heart disease are primary causes of mortality in this hypertensive population.
- The study highlights the critical impact of hypertension on long-term health outcomes and survival.
Abstract:
1. This study includes 1038 patients (325 men and 713 women) who consulted the medical out-patient clinic, Rigshospitalet, Copenhagen, during the years 1932-38. All these patients had a blood pressure of 160/100 mmHg or 180 mmHg or more. 2. The average age at the first examination was 54 years; 97% were followed at intervals of 10 years until 1975, when sixty patients were still alive. Treatment was minimal until 1970. 3. Sixty percent of the men and 76% of the women reached an age of 65 years or more. Nine percent of the total patients lived to 85 years or more. Excess mortality was far higher in men than in women. 4. Causes of death were stroke in 17%, heart failure in 24%, coronary occlusion in 16%, uraemia in 4% and other diseases in 39%. At the first examination, thirteen cases of malignant hypertension were registered, none at later sessions.