The aim of this study was to investigate if mortality during a 13-year follow-up varied between normotensive subjects, screen-detected hypertensive subjects, and subjects with antihypertensive medication at baseline. A population-based screening and intervention program identified 2659 apparently healthy, middle-aged cardiovascular-risk persons in southwestern Finland. Screen-detected hypertension was verified by home blood pressure measurements. Lifestyle counseling was provided for all participants and preventive medications were started or intensified if needed. All-cause and cardiovascular mortality were obtained from the official statistics. Screen-detected hypertension was diagnosed in 17% of the participants, 51% were normotensive and 32% had antihypertensive medication at baseline. The screen-detected hypertensives had higher mean blood pressure and cholesterol levels than the two other groups. Altogether 289 subjects died during the follow-up, 83 (29%) from cardiovascular disease. Those with screen-detected hypertension had decreased cardiovascular mortality risk compared to the medicated hypertensives [sHR 0.40 (95% CI: 0.19 to 0.88, p = 0.023)], and comparable with that of the normotensives [sHR 0.53 (95% CI: 0.24 to 1.15)]. Newly diagnosed diabetes at baseline was a powerful predictor of cardiovascular mortality [sHR 2.71 (95% CI: 1.57 to 4.69)]. Early detection of hypertension and timely multifactorial intervention seem to be important in preventing hypertension-related mortality.

本研究的目的是调查 13 年随访期间血压正常受试者、筛查检测出的高血压受试者和基线时服用抗高血压药物的受试者之间的死亡率是否存在差异。一项基于人群的筛查和干预计划在芬兰西南部识别出了 2659 名表面健康的中年心血管风险人群。通过家庭血压测量来验证屏幕检测到的高血压。为所有参与者提供生活方式咨询，并根据需要开始或加强预防性药物治疗。全因死亡率和心血管死亡率来自官方统计数据。17% 的参与者经筛查诊断为高血压，51% 的参与者血压正常，32% 的参与者在基线时服用了抗高血压药物。筛查检测出的高血压患者的平均血压和胆固醇水平高于其他两组。随访期间共有 289 名受试者死亡，其中 83 名 (29%) 死于心血管疾病。与药物高血压患者相比，筛查检测出高血压的患者心血管死亡风险降低[sHR 0.40（95% CI：0.19至0.88，p  = 0.023）]，并且与血压正常患者相当[sHR 0.53（95% CI：0.24）至 1.15)]。基线时新诊断的糖尿病是心血管死亡率的有力预测因子 [sHR 2.71（95% CI：1.57 至 4.69）]。早期发现高血压并及时进行多因素干预对于预防高血压相关死亡似乎很重要。