Long-surviving hypertensives--a 15-year follow-up.

In a London suburban general practice 87 hypertensives have been followed up for more than 15 years. These represented one third of all those (270) aged 30-59 diagnosed as being hypertensive. Females outnumbered males by 2.5: 1. Most (85 per cent), had mild or moderate high blood pressure at first diagnosis with a diastolic blood pressure less than 120mm Hg.At assessment 15-25 years from first diagnosis, 58 (78 per cent) were still alive and of these 51 (58 per cent) were well and had no obvious ill effects; 17 (20 per cent) had complications from their high blood pressures. Deaths occurred in 19 (22 per cent) after more than 15 years of observation.I suggest that within the condition which we label as hypertension there are many in whom the condition is relatively benign and may be left untreated with hypotensives. These tend to be women rather than men, the older rather than the younger, and those with lower diastolic blood pressures.Once diagnosed, high blood pressure is not necessarily a progressive condition. In one third (30 per cent) of this group the diastolic blood pressures fell during the period of observation, in 18 per cent it remained unchanged and in 52 per cent it rose.