[Is blood pressure treatment as effective in a population setting as in controlled studies?].

Baseline (1974-76) and repeat (1977-81) cardiovascular screenings of 21,314 men aged 35-49 years brought to light 840 men who had started treatment between screenings. These were compared with men who had remained untreated. The effects of treatment on blood pressure were small, and normal target blood pressures rare. At pretreatment blood pressure up to systolic 184 mm Hg, and in most risk strata, both total mortality and cardiovascular mortality were higher among the men on treatment. This study shows an adverse effect of treatment in a population setting, particularly at low pretreatment blood pressure, and if blood pressure increases upon treatment.