Coronary heart disease in residents of Rochester, Minnesota, 1950-1975. III. Effect of hypertension and its treatment on survival of patients with coronary artery disease.

The data in this blood pressure study were obtained from 1,069 patients who had their first manifestation of coronary artery disease during the 16-year period 1960 through 1975. Case fatality rates (death within 30 days) were least in the normotensive and treated hypertensive patients with myocardial infarction and greatest in the untreated hypertensive patients. Women were less likely than men to acquire coronary artery disease, but a higher proportion of women with coronary artery disease had hypertension. Patients with definite hypertension were older than those with borderline hypertension, and patients with borderline hypertension were older than normotensive patients with coronary artery disease. The data demonstrate that hypertension is a prognostic factor of serious significance in patients who have symptomatic coronary artery disease, and the prognostic significance of borderline hypertension is almost as serious as that of definite hypertension in these patients. Treatment improved survival in patients with definite hypertension, and adequate treatment improved survival to a greater degree than did inadequate treatment.