Essential Hypertension

Abstract

For 540 traced patients with essential hypertension, 10- and 20-year survival rates were lower than for a normal population of similar age and sex distribution and correlated well with the Keith-Wagener-Barker ophthalmoscopic grouping of hypertensive patients. For each level of diastolic blood pressure, the prognosis worsened from the lower to the higher opthalmoscopic groups. Azotemia, proteinuria, and inverted T wave in the electrocardiogram had an increasingly serious prognostic import from lower to higher ophthalmoscopic groups. Myocardial infarction, congestive heart failure, and cerebral vascular accident were each associated with higher mortality rates than that for the entire number of patients within each ophthalmoscopic group. Changes in the optic fundi (Keith-Wagener-Barker classification) remain the simplest, most practical and most accurate guide to prognosis in essential hypertension, with or without complications.