[A forty-year study on hypertension].

Since 1959 the investigations on prevalence of hypertension and studies on the prevention and treatment of this disease have been carried out. The vascular mechanism of hypertension and the depressor effect of Chinese traditional herbs were also studied in Chinese Academy of Medical Sciences. The results revealed that: (1) The prevalence of hypertension in Chinese adults increased from 7.73% in 1979 to 11.26% in 1991, both much higher than that in 1959 (5.11%). The rate of awareness, treatment and control was only 26.3%, 12.1%, and 2.8% respectively. The risk factors of hypertension included overweight and alcohol drinking. High sodium, low potassium, low calcium, and low animal protein diet were also very important risk for elevation of blood pressure. Hypertension was the most important causal risk factor of coronary heart disease and stroke. (2) Hypertension diagnosis and staging criteria were established in 1959. Secondary hypertension was found to constitute 1.1% among community hypertensive patients. The new concept of aortitis was formed and found to be the most common cause of renal vascular hypertension. Patient education together with low dose compounds of antihypertensive drugs was implicated widely. Randomized clinical trials Syst-China, Post-stroke Antihypertensive Treatment Study, Chinese Acute Stroke Trial, and Chinese Cardiac Study 1 demonstrated benefits of treatment for hypertensive, stroke or acute myocardial infarction affordable by Chinese population at large. (3) A series of functional changes and abnormalities with evident hereditary characteristics were found in the processes of cellular Ca2+ transportation, utilization, metabolism and their modulation of the vascular smooth muscle in SHR, and SHRsp, which seem to be the principal cause of the increase in peripheral vascular resistance in hypertension. (4) Alkaloid of Rauwolfia verticilata and Ligustrazine had marked depressor effect. Flavones of Radix Pueraricae could reduce the cardiac and cerebral ischemic damage and symptoms in hypertensive patients.