Sinclair A M, Isles C G, Brown I, Cameron H, Murray G D, Robertson J W
Arch Intern Med. 1987 Jul;147(7):1289-93.
The prevalence, reversibility, and mortality of secondary hypertension among 3783 patients with moderately severe nonmalignant hypertension attending the Glasgow (Scotland) Blood Pressure Clinic were assessed. Underlying causes of hypertension were found in 297 patients (7.9%). Eighty-seven patients (2.3%) were considered to have a potentially reversible cause for their hypertension, including the oral contraceptive pill (38 patients), renovascular disease (27 patients), and primary hyperaldosteronism (ten patients), but of these only 33 patients (0.9% of total clinic population) were cured by specific intervention. Two hundred ten patients (5.6%) had irreversible renal parenchymal disease and significantly higher mortality than men and women with other causes of hypertension. Excess deaths in the renal group were attributed to renal failure (International Classification of Diseases [ICD] 580 to 589) and vascular causes (ICD 390 to 458) but not to cancer (ICD 140 to 208; 235 to 239) or other nonvascular disease. These results suggest that investigation of hypertension for an underlying cause will reveal a small number of patients with treatable disorders, of whom only a few will be cured by specific intervention, and a moderate number with irreversible disease who are at high risk of myocardial infarction and stroke.
对格拉斯哥（苏格兰）血压诊所的3783例中度严重非恶性高血压患者的继发性高血压患病率、可逆性及死亡率进行了评估。在297例患者（7.9%）中发现了高血压的潜在病因。87例患者（2.3%）被认为其高血压存在潜在可逆病因，包括口服避孕药（38例）、肾血管疾病（27例）及原发性醛固酮增多症（10例），但其中只有33例患者（占诊所总人数的0.9%）通过特异性干预得以治愈。210例患者（5.6%）患有不可逆性肾实质疾病，其死亡率显著高于患有其他高血压病因的男性和女性。肾病组的额外死亡归因于肾衰竭（国际疾病分类[ICD]580至589）和血管性病因（ICD 390至458），而非癌症（ICD 140至208；235至239）或其他非血管性疾病。这些结果表明，对高血压潜在病因进行调查将发现少数患有可治疗疾病的患者，其中只有少数患者能通过特异性干预治愈，还有相当数量患有不可逆疾病的患者，他们发生心肌梗死和中风的风险很高。
