Mortality amongst patients of the Glasgow Blood Pressure Clinic was high in the 1970s and 80s but has fallen since, why?

Established in 1968 the Glasgow Blood Pressure Clinic has over 11,000 patie nts on its computer record. Up to 1980, mortality from all-causes and from cardiovascular causes was high: relative risks compared with two local cont rol 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 cardiova scular causes, particularly coronary heart disease, contributes to the decr ease. Reasons for the decrease are under investigation currently. Referral of patients with slightly lower blood pressure contributes, as may better b lood pressure control with newer antihypertensive drugs. ACE inhibitors and calcium channel blockers were introduced in 1980 and during the 16-year pe riod to 1995, all-cause mortality has decreased most in patients taking ACE inhibitor. A decrease also occurred in patients taking antihypertensive dr ugsother than ACE inhibitor.