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Coronary heart-disease after treatment of hypertension
Insights
Antihypertensive treatment significantly reduced overall mortality in middle-aged men with hypertension. This intervention also lowered the combined incidence of fatal and non-fatal coronary heart disease (CHD), suggesting a protective effect.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Preventive Cardiology
Background:
- Hypertension is a major risk factor for cardiovascular events.
- Effective management of high blood pressure is crucial for reducing morbidity and mortality.
- Middle-aged men represent a key demographic for cardiovascular disease prevention strategies.
Purpose of the Study:
- To evaluate the impact of antihypertensive treatment on cause-specific death rates and myocardial infarction incidence.
- To compare outcomes in treated hypertensive men versus a control group with less intensive management.
- To assess the effectiveness of blood pressure control in preventing coronary heart disease (CHD).
Main Methods:
- A cohort of 1026 men aged 47-54 with severe hypertension was studied over 4.3 years.
- A treatment group (635 men) received antihypertensive therapy, while a control group (391 men) remained largely untreated.
- Outcomes included death rates, non-fatal myocardial infarction, stroke, and pooled fatal/non-fatal CHD events.
Main Results:
- The treatment group had a significantly lower total death rate (3.3% vs. 6.1%) compared to the control group.
- While not statistically significant individually, CHD death rates and non-fatal myocardial infarction incidence were lower in the treated group.
- The pooled incidence of fatal and non-fatal CHD was significantly reduced in the treatment group (3.6% vs. 6.9%).
Conclusions:
- Antihypertensive treatment appears effective in reducing overall mortality in middle-aged men with severe hypertension.
- The findings suggest that treating hypertension may prevent or delay the onset of coronary heart disease.
- Aggressive blood pressure management is a vital strategy for cardiovascular risk reduction in this population.
Abstract:
Within a group of 1026 men aged 47-54, cause-specific death-rates and the incidence of non-fatal myocardial infarction and stroke in treatment group of 635 hypertensive men (casual systolic B.P. greater than 175 or diastolic B.P. greater than 115 mm Hg on two occasions) treated at a hypertension clinic were compared with those in a control group of 391 men (causal systolic B.P. greater than 175 or diastolic greater than 115 mm Hg on only one occasion) who remained mainly untreated during their 4.3 years of follow-up. The predicted risk of coronary heart-disease (C.H.D.) at entry, calculated by a multiple logistic function, was slightly higher in the treatment group. Total death-rate during follow-up was significantly lower in the treatment group (3.3%) than in the control group (6.1%). The difference in death-rate for C.H.D. was of the same relative order (0.8% versus 1.5%), as was the incidence of non-fatal myocardial infarction (2.8% versus 5.4%), although none of the differences reached statistical significance. However, the pooled incidence of fatal and non-fatal C.H.D. was significantly lower in the treatment group (3.6%) than in the control group (6.9%). The results suggest that antihypertensive treatment might be effective in preventing or postponing C.H.D. in middle-aged men.