Old patients with hypertension. A 25-year observational study of a geographically defined population (Dalby), aged 67 years at entry

Objectives. To evaluate the impact of hypertension and other risk factors o n mortality, in particular cardiovascular mortality, in a geographically de fined population of elderly subjects, Design, An observational 25-year study of a total population. Setting. The local health centre in the village of Dalby in southern Sweden , Subjects, All men and women born in 1902 or 1903, living in Dalby, were, at the age of 67, invited for medical and psychological examinations. The pop ulation comprised 188 subjects (109 men and 79 women): 156 (83%) of them to ol; part in the first medical examination. Blood pressure, heart rate, weig ht and height were measured and laboratory tests performed at entry, Blood pressures were thereafter recorded six times, and this report is based on a 25-year follow-up period ending in October 1994. Main outcome measures. Survival analyses were performed, based on definitio n of underlying causes of death, divided into all-cause and cardiovascular. Results, At entry, females had higher blood pressure than males, both at ba seline and during the first 16 pears of the study, regardless of whether th ey were hypertensives or not. Most men smelted but only a few women. At the end of the follow-up of the present study in 1994, 138 out of 156 (88%) su bjects had died and only 18 (12%) remained alive; 78 (57%) had died of a ca rdiovascular disease, In men, a diagnosis of hypertension as well as increa sed blood pressure at entry was associated with increased mortality. In wom en this was the case for blood pressure and risk of cardiovascular mortalit y In men, both systolic and diastolic blood pressures during the study were significant risk factors for death, whereas in women this was not the case . Conclusions. Elderly male hypertensives ran an increased mortality risk eve n though they were treated according to the then current guidelines: female hypertensives seemed to run the same risk of dying as normotensive females .