Effectiveness of Prolonged Antihypertensive Treatment on Survival of Patients with Essential Hypertension

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The results of 2 comparative studies based on 2 different times of follow-up surveys of essential hypertension were presented. The greater part of the materials were of benign types. In order to evaluate the effect of prolonged systematic treatment, patients who died within 6 months of registrations were excluded from the materials, and the prognosis of a group of patients who sustained such treatment was compared with the others.(1) Study I (based on survey at 1959). Among 489 consecutively selected materials, 125 patients sustained the treatment (Group A). Remaining cases were classified as following 3 groups on the basis of a history of treatment during the observation periods; 65 cases discontinued the treatment after more than 6 months' duration averaging 14 months (Group B), 135 cases had an experience of any other hypotensive regimen (Group C), and 164 cases had no considerable medications of the drugs (Group D). No practical differences of the initial severity and other conditions were found between Groups A and B; and the severities of Groups C and D were identical with each other, indicating distinctly lower than the formers.The mortality of Group A was found significantly lower than Group B (p<0.01), and was markedly lower than C and D. No remarkable difference was found between the latter 2 Groups. The course of Group B was rather poor as compared with Group D. In Group B, most of cerebral deaths developed within a year of discontinuing the treatment.(2) Study II (based on survey at 1962). Prognostic features were analysed between a group of patients who sustained the systematic treatment (treated series, 157 cases) and a group of those of others (control series, 266 cases), from the point of identical category of retinal gradings. The initial severity was almost identical with each grade of both series, or slightly higher in treated series. They had longer observation period than controls. A significantly lower mortality was found in treated series of grades II and IV. In grades I and III, mortality difference in per cent basis was remarkable but failed to reveal a statistical significance. Concerning a group of benign hypertensives, mortality was significantly lower in treated series. Particular emphasis was made on distinctly improved course of treated grade II, and analyses and discussions were made concerning less satisfactory difference in grade III.(3) Practical difficulties attendant upon the evaluations of the effect of treatment which demands critical analyses have been especially taken into considerations and discussed.It was emphasized that, in a case of persistent hypertension, satisfactory life-prolonging effect may be largely expected by prolonging available treatment even in a "milder" hypertensive patients.
International Heart Journal刊行会の論文

Effectiveness of Prolonged Antihypertensive Treatment on Survival of Patients with Essential Hypertension

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