The Australian National Blood Pressure Study: A Test of the Effectiveness of Antihypertensive Therapy on the Incidence of Ischaemic Heart Disease

1976 ◽  
Vol 6 (5) ◽  
pp. 403-406 ◽  
Author(s):  
J. D. Abernethy
1976 ◽  
Vol 51 (s3) ◽  
pp. 645s-647s
Author(s):  
J. D. Abernethy ◽  
J. L. Baker ◽  
M. U. Bullen ◽  
M. L. Lamb ◽  
M. R. Stewart

1. The National Blood Pressure Study (NBPS) is a single blind trial designed to test the efficacy of active drug treatment in reducing complications from mild hypertension (mean diastolic pressure = 95–109 mmHg). 2. Between 1973 and 1975, four centres screened about 104 000 subjects aged 30–69 years, yielding an estimated prevalence of hypertension (≥95 mmHg diastolic) of 16% and of moderate-to-severe hypertension (≥110 mmHg diastolic) of 1·3%. 3. Some 4000 subjects selected for untreated uncomplicated mild hypertension were randomized to either active treatment (chlorothiazide + α-methyldopa and/or a β-adrenoreceptor antagonist as required) or to matching placebos. 4. At 1 year mean pressures had fallen significantly below entry pressures in both groups but in the active group the fall was greater by a margin of 14·4±1·3 (sem) mmHg systolic and 71 ±0·7 mmHg diastolic. At 1 year 5% of subjects in the placebo group had been placed on active treatment on the ethical grounds that pressure had exceeded the mild hypertension limit. 5. Trial end-points (death, morbidity from stroke, hypertensive heart and renal disease, and ischaemic heart disease) number 106 (nine deaths) thus far, of which ischaemic heart disease accounts for 71% and stroke 19%. 6. The duration of trial may need to be extended beyond the original estimate of 5 years.


BMJ ◽  
1982 ◽  
Vol 284 (6323) ◽  
pp. 1148-1151 ◽  
Author(s):  
L Harris ◽  
H J Dargie ◽  
P G Lynch ◽  
C J Bulpitt ◽  
D M Krikler

1998 ◽  
Vol 60 (1) ◽  
pp. 105
Author(s):  
D. Carroll ◽  
G. Davey Smith ◽  
G. Willemsen ◽  
D. Sheffield ◽  
P.M. Sweetnam ◽  
...  

1992 ◽  
Vol 10 (10) ◽  
pp. 1273-1278 ◽  
Author(s):  
Christopher J. Bulpitt ◽  
Alison J. Palmer ◽  
Astrid E. Fletcher ◽  
D Gareth Beevers ◽  
Edward C. Coles ◽  
...  

Author(s):  
Sheetal Ratankumar Gatagat

Introduction:  Hypertension is a major public health issue worldwide, affecting millions of patients. Although control rates have improved during the past few years, the actual rate is still unacceptably low, and control rates in more vulnerable populations, like people living with diabetes mellitus, are even lower. Optimal BP control could prevent a high percentage of coronary heart disease events, and early BP control significantly reduces the risk of stroke and cardiovascular events Depression is usually not detected at primary levels, and patients do not typically receive adequate treatment, which may not only affect their quality of life, but may also interfere with the treatment and prognosis of other chronic diseases such as ischemic heart disease and stroke.  Material and Methods: 46 hypertensive patients undergoing antihypertensive therapy for longer than six months were included in the study. After a 5 min of rest period, measurement of BP was recorded in triplicate at 3 min intervals between measurements. Adherence to antihypertensive therapy was monitored. All patients completed the Zung Self-rating Depression Scale survey; depression was diagnosed if the patient scored >50 points (the maximum possible score using this scale was 80). The Zung Self-rating Depression Scale is said to be a sensitive measure of clinical severity in depressed patients. Results: Out of 46 patients there were 22 (47.8%) female and 24(52.2%) male. Patients who were depressed were 20 (43.5%) of which 8(40%) were male and 12 (60%) were female. Of the total 20 depressed patients 1 male having controlled hypertension while 19 (80%) were in the group of uncontrolled diabetes. In controlled hypertension group only 1 mild depression patient was observed while in uncontrolled group of the 19 patients 10 (50%) were having mild, 8 (40%) were having moderate and 1 (20%) were having severe depression according the Zung Self-rating Depression Scale. Mean blood pressure in depressed controlled BP group was 128/73 mmHg while in depressed uncontrolled group was 149/90 mmHg. Mean blood pressure in normal controlled BP group was 121/75mmHg while in depressed uncontrolled group was 146/95 mmHg. There was a significant correlation observed between depression and systolic and diastolic blood pressure value (P<0.001). Conclusion: Depression is common in patients having uncontrolled hypertension and screening of depression in hypertensive patients is simple and effective tool to control the hypertension. Keywords: Hypertension, Depression, controlled, uncontrolled.


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