Survival of treated hypertensive patients as a function of compliance and control

In the 1950s, 223 white patients had varyingly severe hypertension controlled in hospital with ganglioplegic agent and hydralazine. At home, each was instructed to take and record his/her blood pressure (BP) four or five times per day and to bring all BP records to the next treatment visit. Our file of home BP records exactly one year after treatment began was used to divide the patients into: non-compliant; compliant but uncontrolled; controlled. There were 56 non-compliant, 60 compliant but uncontrolled, and 107 controlled patients. Their respective median survival times after beginning therapy were 56.5, 134, and 153 months. Thus, survival was a strong function of compliance and a significant but weaker function of control. The non-compliant quarter of the group survived an average of less than five years, while the controlled half survived an average of more than 12 years.