Treated blood pressure, rather than pretreatment, predicts survival in hypertensive patients A report from the DHSS Hypertension Care Computing Project (DHCCP)

Abstract

A group of hypertensive patients (n=2855) with an untreated diastolic blood pressure ≥90 mmHg were followed in the Department of Health and Social Security (DHSS) Hypertension Care Computing Project (DHCCP) for periods of up to 10 years. During this period 191 of these patients died. Survival was assessed in relation to pretreatment blood pressure levels and blood pressure achieved during treatment. The blood pressure during treatment was a useful predictor of mortality, but the pretreatment pressure was not. After adjusting for age, mortality was particularly related to the height of the systolic and diastolic blood pressure during the second and third years of treatment. In men, age-standardized 5-year mortality was >10% in those with a first year treated systolic pressure >150 mmHg or a diastolic pressure >95 mmHg. In women, age standardized 5-year mortality was >5% with the same levels of treated blood pressure. The longest survival occurred with the lowest bands of treated pressure, i.e. systolic pressure <140 and diastolic pressure <90 mmHg; the 5-year mortality being < 7% in men and < 3% in women. Treated systolic and diastolic pressures were useful in predicting death from ischaemic heart disease (IHD).