AIMS This study determined whether the improvements in hypertension management over the last five decades have influenced subjects' prognosis. METHODS AND RESULTS The study considered 5693 eligible subjects seen January 1969 to February 1991 (follow-up until December 2003) or January 1995 to October 2014 (follow-up until July 2016) in an all-grade hypertension reference centre. Missing data or incomplete follow-ups led to exclude 1036 subjects (18%). The outcome was all-cause death. An adjusted modelling of the excess mortality rate assessed subjects' net survival over five inclusion periods to allow for the increase in life expectancy of the general population during the same periods. The analysis of 4657 records (mean age: 47 years; 43.2% women) showed that the proportion of subjects with grade 3 hypertension decreased significantly from 43.3% (1142) to only 6.3% (22) over the five periods and that the net survival improved in men and women regardless of the hypertension grade; i.e. the gain in net survival at 15 years was estimated at 12.3% (95% confidence interval: 8.1-22.3). The 15-year restricted mean survival was estimated at 13 years over the first period and 14.8 years over the last period, which is nearly a 2-year gain in life expectancy at 15 years. CONCLUSION Since the 70s and the advent of modern management, the excess mortality of hypertensive subjects (vs. the general population) was markedly reduced. Within a context of trivialization of blood pressure measurement and reluctance to long-term treatments, physicians should consider this advantage and use it to promote blood pressure control.

中文翻译：

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在过去的半个世纪中，通过控制高血压来提高净生存率。

目的 本研究确定了过去五年间高血压管理的改进是否影响了受试者的预后。方法和结果 该研究考虑了 1969 年 1 月至 1991 年 2 月（随访至 2003 年 12 月）或 1995 年 1 月至 2014 年 10 月（随访至 2016 年 7 月）在全级别高血压参考中心的 5693 名合格受试者。数据缺失或随访不完整导致排除 1036 名受试者 (18%)。结果是全因死亡。超额死亡率的调整模型评估了受试者在五个纳入期间的净存活率，以允许在同一时期内增加一般人群的预期寿命。分析 4657 条记录（平均年龄：47 岁；43. 2% 的女性）显示，在五个时期内，患有 3 级高血压的受试者比例从 43.3%（1142 人）显着下降至仅 6.3%（22 人），无论高血压等级如何，男性和女性的净生存率都有所提高；即 15 年的净生存率估计为 12.3%（95% 置信区间：8.1-22.3）。第一个时期的 15 年受限平均生存期估计为 13 年，最后一个时期估计为 14.8 年，这与 15 岁时的预期寿命增加了近 2 年。结论 自 70 年代和现代管理的出现以来，高血压患者（相对于普通人群）的超额死亡率显着降低。在血压测量微不足道和不愿长期治疗的背景下，