Detection,Treatment and Follow-up of Hypertension in a Community Sample of 55-Year-Old Men

Abstract

In connection with a population study including 703 randomly selected 55-year-old men, 20 men with the highest blood pressure were selected for a careful follow-up and treatment for 1 year. Controls without hypertension were randomly selected from the remainder of the same population. Electrocardiogram at rest and in connection with an exercise test, changes in fundus oculi, orthostatic tests, peripheral arterial blood flow, chemical analyses and other variables were recorded on three occasions during the observation year. Drug treatment was standardized. Basic treatment was induced with polythiazide, which normalized the blood pressure in the majority of the hypertensive cases. The most striking findings in the hypertensive group before treatment were, besides the high blood pressure at rest, high blood pressure during exercise, an increased peripheral blood-flow through the calves, and an increased heart-rate. During treatment, the blood pressure were selected for a careful follow-up and blood-flow were almost “normalized”; the heart-rate remained elevated. The investigation shows that it is quite easy to achieve adequate reduction of blood pressure in hypertension among middle-aged men, as found in the “real world” outside the hospital. The main problem today is not to normalize the blood pressure but rather to detect hypertension and to maintain the therapy for several years. Hypertension is considered to be the cardiovascular risk factor that is probably most amenable to preventive approaches to public health.