Bulpitt C J
Br J Clin Pharmacol. 1982 Jan;13(1):73-9. doi: 10.1111/j.1365-2125.1982.tb01340.x.
1 The 5 year survival of hypertensive patients in several studies was reviewed to demonstrate the adverse effects of increasing age, being male, having a higher untreated blood pressure of severe retinal changes. 2 The decrease in survival with increase in diastolic blood pressure was not linear, mortality being relatively constant below 90 mmHg. 3 The adverse effect of severe retinal changes was independent of the untreated blood pressure. 4 In patients selected with mild hypertension, 5 year survival can exceed 97% even when untreated. 5 Owing to the lack of suitable data we cannot conclude that treatment was more effective in prolonging life in the 1970s than in previous decades. 6 In the United States non-white patients with hypertension fared worse than white patients. 7 The serum cholesterol was not positively related to mortality in treated hypertension patients. 8 Treated hypertensive patients who smoked had at least a two-fold increase in mortality over those who did not. 9 Treated patients under the age of 50 years had a four-fold increase in mortality compared with the general population. This was greater than any excess mortality observed in the elderly.
回顾了多项研究中高血压患者的5年生存率,以证明年龄增长、男性、未治疗时血压较高以及严重视网膜病变的不良影响。
随着舒张压升高生存率的下降并非呈线性,舒张压低于90 mmHg时死亡率相对稳定。
严重视网膜病变的不良影响与未治疗时的血压无关。
在轻度高血压患者中,即使未经治疗,5年生存率也可超过97%。
由于缺乏合适的数据,我们无法得出20世纪70年代治疗在延长寿命方面比前几十年更有效的结论。
在美国,高血压非白人患者的情况比白人患者更糟。
在接受治疗的高血压患者中,血清胆固醇与死亡率无正相关。
接受治疗的吸烟高血压患者的死亡率比不吸烟的患者至少高出两倍。
50岁以下接受治疗的患者死亡率比普通人群高出四倍。这比在老年人中观察到的任何额外死亡率都要高。