title: Changes in clinical characteristics and drug treatment of hypertension over 40 years at the Dunedin Hypertension Clinic.
abstract: The clinical characteristics of the 4,170 hypertensive patients referred to the Dunedin Clinic from 1950 to 1989 have been compared for eight successive 5-year periods. A gradual decrease in the severity of referred hypertension and an increase in the proportion of patients already on treatment at the time of referral (currently 50%) were noted. For male patients, mean +/- SD initial lying blood pressure was 179 +/- 27/116 +/- 19 mm Hg in 1950-1954 and 158 +/- 25/91 +/- 14 mm Hg in 1985-1989. Corresponding prevalence data for target organ damage among male patients were retinal grade 3 or 4, 49% and 3%; cardiomegaly on chest radiograph, 60% and 26%; electrocardiogram left ventricle strain pattern, 28% and 3%; and serum urea levels greater than 10 mmol/L, 16% and 5%, respectively. For women there was a similar trend. The number of patients on drugs in each of nine categories and the percent use of each drug category for each year during 1950-1989 was recovered from computerized data files. The percentage peak usage of ganglion blockers was in 1950-1958, adrenergic neuron blockers in 1963-1970, centrally acting drugs in 1965-1968, diuretics in 1960-1982, beta-blockers in 1974-1987, alpha-blockers in 1980-1987, and angiotensin converting enzyme inhibitors and calcium antagonists in 1989. The diuretics have been the most enduring drugs, followed by the beta-blockers.
authors.affiliation: Wellcome Medical Research Institute, University of Otago Medical School, Dunedin, New Zealand.
authors.forename: H J
authors.initials: HJ
authors.lastname: Waal-Manning
authors.forename: J M
authors.initials: JM
authors.lastname: Paulin
authors.forename: A T
authors.initials: AT
authors.lastname: Wallis
authors.forename: F O
authors.initials: FO
authors.lastname: Simpson
mesh_terms: D000554:Ambulatory Care Facilities; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012737:Sex Factors
chemical_list: D000959:Antihypertensive Agents