Cruickshank J M, Thorp J M, Zacharias F J
Lancet. 1987 Mar 14;1(8533):581-4. doi: 10.1016/s0140-6736(87)90231-5.
To investigate whether the lower the blood pressure (BP) the better the prognosis for the patient with moderate-to-severe hypertension, an assessment was made of 902 patients who received the beta 1-selective beta-blocker atenolol (median dose 100 mg a day), either alone or with other antihypertensive agents, for up to 10 years (mean 6.1). 91 died, 40 from myocardial infarction, 21 from stroke, and 30 from other causes. Initial BP was a poor predictor of mortality from myocardial infarction, whereas treated systolic blood pressure (SBP) was a strong predictor. There was a J-shaped relation, confined to those with evidence of ischaemic heart disease, between frequency of death from myocardial infarction and treated DBP (phase V); the frequency was lowest at treated DBP of 85-90 mm Hg and rose with treated DBP on either side of this range.
为了研究中重度高血压患者的血压（BP）是否越低预后越好，对902例患者进行了评估，这些患者单独或与其他抗高血压药物联合使用β1选择性β受体阻滞剂阿替洛尔（中位剂量为每日100mg），治疗时间长达10年（平均6.1年）。91例死亡，40例死于心肌梗死，21例死于中风，30例死于其他原因。初始血压对心肌梗死死亡率的预测能力较差，而治疗后的收缩压（SBP）是一个强有力的预测指标。在有缺血性心脏病证据的患者中，心肌梗死死亡频率与治疗后的舒张压（第V期）之间存在J形关系；治疗后的舒张压为85 - 90mmHg时，频率最低，在此范围两侧随着治疗后的舒张压升高而上升。
