Objectives Eight years of follow-up studies of 163 hypertensive patients, comparing the different medication used, frequency of exercise and analysing their correlation factors. The death rate and cardiovascular events in this group of patients were recorded.
Methods The clinical data from 163 hypertensive patients (age ≥ 50 and < 80, Bp ≥ 140/90 mmHg) with at least one risk factor (TC ≥ 220 mg·dL-1 (5.7 mmol·L-1); fasting blood glucose ≥ 126 mg·dL-1 (7.0 mmol·L-1); postprandial blood sugar ≥ 200 mg·dL-1 (11.1 mmol·L-1); of BMI ≥ 28 kg·m-2) were collected at baseline and followed up for eight years. The gender, age, BMI, education, blood pressure, blood glucose, cholesterol, triglyceride, anti-hypertension medication, frequency of exercise and cardiovascular end points were recorded after informed consent in March, 2005.
Results 27 cases were lost during eight years of follow-up. Nineteen patients were dead. The average age of patients was 64.64 ± 7.92 (50-80) years, and 40.49% of participants were men. The mean blood pressure of Year 2005, 2009 and 2013 were 167/91 ± 40/13 mmHg, 142/81 ± 14/12 mmHg and 142/77 ± 12/12 mmHg respectively. Exercise frequency per week per person of Year 2005, 2009 and 2013 were 1.3, 3.9 and 4.5 respectively. The logistic regression analysis showed that the affecting factors included the patients over the age of 60, high education (P = 0.01) and lower BMI equation (P = 0.022). On the contrary, the workaholic and higher BMI patients did much less exercise. Percentage of patients using only one drug for hypertension in 2005, 2009 and 2013 were 26.9%, 34.1% and 21.96% respectively. The percentage of drugs used in 2005, 2009 and 2013 were ACEI 16.67%, 14.29% and 7.63%; ARB 7.94%, 11.11% and 28.81%; β blocker 47.62%, 30.95% and 30.51%; calcium channel blocker 66.67%, 64.29% and 61.86%; diuretic 46.83%, 19.84% and 13.56%; ASA16.8%, 17.5% and 19%. 11 cases of cardiovascular, 10 strokes and 10 cancer events happened during the eight year period. Three out of the 11 cardiovascular diseases resulted in death (27.3%), 4/10 stroke died (40%) and 8/10 cancer were died (80%). Among the 19 deaths, 3 were heart disease (one was AMI, and two sudden death), 4 were stroke and 8 were cancer (2 stomach, 3 hepatocarcinoma, 1 lung, 1 pancreatic, and 1 cervical cancer). Another 3 death were of unknown aetiology.
Conclusions The eight years’ follow-up showed four key points: (1) the blood pressure was better controlled compared to eight years ago. (2) Calcium channel blocker were most commonly used (accounted for about 65%) among five common antihypertensive drugs in these eight years. Diuretics and β blockers were not used as much as before, while ARBs were used more compared to eight years ago. (3)The hypertensive patients were more inclined to do exercise in these years. The frequency and amount of exercise were positively related to age over 60, higher education and lower body weight. (4) Cancer is still the first killer in aged population in Dalian, even though there is higher incidence of cardiovascular disease in hypertensive population but the death rate due to cardiovascular disease is not as higher as cancer.