Effects of Long-term Treatment with Hypotensive Drugs in Patients of Essential Hypertension, with Special Reference to the Death Rate of the Patients

　165 patients with essential hypertension, including 106 patients treated for more than 12 months, were treated with various hypotentive agents over a period of 6 to 45 months, and the effects of the anti-hypertensive therapy on renal blood flow, electrocardiographic abnormalities, retinal findings, occurrences of cerebral and cardiac complications and the death rate were investigated in these treated patients, in comparison with untreated patients.

　Of 86 treated patients, renal blood flow showed a significant increase in 35% and decrease in 14%, whereas of 16 untreated patients it showed an increase in none and decrease in 75% during the same period of observation.

Retinal findings showed improvement in 18% and aggravation in 3% of 133 treated patients, whereas they showed improvement in none and aggravation in 44% of 16 un-treated patients during the same period. Electrocardiographic findings showed im-provement in 38% and aggravation in 8% of 63 treated patients.

　Increasing improvement in these ob-jective manifestations were observed with duration of treatment when blood pressure was maintained in a sufficiently reduced level.

　Maintenance dosages of hypotensive agents were observed to have a tendency to decrease with the duration of treatment, when suffi-cient hypotensive effects were maintained in patients treated for over 24 months.

　With respect to occurrences of cerebral and cardiac complications and to the death rate, statistically significant differences were demonstrated between 97 treated and 53 untreated patients without severe renal damage, in whom difference of the severity of hypertension was small. The death rate during an average period of 21.3 months was 2% in the treated group as compared with 15% in the untreated group.

　It appears 'evidently that adequate and prolonged antihypertensive therapy may improve the objective manifestations, prevent occurrences of important complications and lower the fatality rate in patients with essential hypertension.