Why the study?
Has mortality among patients at a specialized blood pressure clinic decreased over time with the introduction of newer antihypertensive therapies?
Has mortality among patients at a specialized blood pressure clinic decreased over time with the introduction of newer antihypertensive therapies?
Mortality among hypertensive patients in a specialized clinic significantly decreased after 1980, coinciding with the introduction of ACE inhibitors and calcium channel blockers.
Mortality decline in hypertension clinic patients since 1980 was associated with ACE inhibitor use; hypothesis-generating and requires prospective confirmation.
Established in 1968 the Glasgow Blood Pressure Clinic has over 11,000 patients on its computer record. Up to 1980, mortality from all-causes and from cardiovascular causes was high: relative risks compared with two local control populations were greater than 2.0. Since 1980, all-cause mortality has decreased to 1.31 (859 deaths, CI 1.23-1.39). Lower mortality from cardiovascular causes, particularly coronary heart disease, contributes to the decrease. Reasons for the decrease are under investigation currently. Referral of patients with slightly lower blood pressure contributes, as may better blood pressure control with newer antihypertensive drugs. ACE inhibitors and calcium channel blockers were introduced in 1980 and during the 16-year period to 1995, all-cause mortality has decreased most in patients taking ACE inhibitor. A decrease also occurred in patients taking antihypertensive drugs other than ACE inhibitor.
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Lever et al. (1999) studied this question.
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