Hypertension and Associated Cardiovascular Disease

• The five-year mortality rates have been obtained for 1,118 male and 1,109 female patients classified into four groups by a method of scoring objective cardiovascular findings. Group 1 contained patients with hypertension but no cardiovascular disease. Groups 2 and 3 contained patients with increasing degrees of damage in the cerebral, cardiac, or renal areas. Group 4 contained the patients with the most advanced cardiovascular changes. The tabulations show that the prognosis becomes worse as signs of cardiovascular-renal damage increase and that within each of the groups the prognosis for females with hypertensive cardiovascular disease is better than for males. Patients treated surgically by a one-stage bilateral lumbodorsal spianchnicectomy are compared with patients receiving only medical treatment. The mortality rates were significantly better in all four groups of surgically treated male patients and in groups 2 and 3 of the surgically treated female patients. In either sex, the prognosis for group 4 was shown to be poor. It is believed that patients of groups 2 and 3 in general should be treated surgically, especially if medical treatment has been found ineffective after a trial of 8 to 10 weeks.