Angina pectoris, intermittent claudication and congestive heart failure in middle-aged male hypertensives. Development and predictive factors during long-term antihypertensive care. The Primary Preventive Trial, Göteborg, Sweden.

A group of middle-aged male hypertensives, derived from a random sample of a Swedish urban population, has been treated and followed for 10 years. The development of angina pectoris, intermittent claudication and congestive heart failure have been analysed. The initial prevalence and the average yearly incidence of angina pectoris was 3.9% and 1.3% p.a., of intermittent claudication 1.7% and 0.6% p.a. and of heart failure 1.0% and 0.8% p.a. ECG signs indicating subclinical heart disease (major Q wave, ST depression, T wave inversion) were risk factors for development of angina pectoris and congestive heart failure. Heart enlargement on chest X-ray was also a risk factor for development of congestive heart failure, as were a high serum creatinine, body mass index, serum uric acid and proteinuria. Smoking was found to be a strong and independent risk factor for any one of these cardiovascular disorders. After 10 years about one fourth of all patients, still attending the clinic, had at least one cardiovascular complication. Hence, the risk of developing cardiovascular disorders is substantial and seems to be potentiated by the same risk factors known to operate in the general population.