Untreated hypertensives and their quality of life.

Two groups of untreated and treated subjects with persistent manifest or borderline hypertension were identified within a prospective study on cardiovascular risk in 416 middle-aged male blue-collar workers. They were compared with respect to four dimensions of quality of life: physical symptoms, mental alertness, emotional well-being and work performance. Only one symptom (nocturnal sleep disturbances) was significantly less frequent in the untreated group. Whereas short-term benefit from drug refusal seems limited, long-term costs in terms of subclinical end-organ damage are considerable. Echocardiographic findings demonstrated early stages of left ventricular hypertrophy (LVH) in one-third of the subjects with persistent borderline hypertension. Considering the role of LVH in cardiovascular mortality, results suggest that we should reinforce diagnostic and therapeutic activities in subjects with persistent borderline hypertension.