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The 40th anniversary of the publication in 1964 of the first trial of the treatment of uncomplicated, severe hypertension by Hamilton, Thompson and Wisniewski

Journal of Human Hypertension volume 18, pages 831–833 (2004)Cite this article

The year 2004 marks the 40th anniversary of the publication of the first controlled clinical trial of the treatment of non-malignant essential hypertension.1 Previous open studies had been confined to patients with very severe or malignant phase hypertension.2, 3 They were mainly based on historical or retrospective controls and therefore could not be regarded as true clinical trials. Also they had largely relied on the ganglion-blocking drugs including hexamethonium. They had, however strongly suggested that antihypertensive therapy did reduce the incidence of strokes and heart failure in these very sick patients.

In their 1964 paper, Hamilton, Thompson and Wisniewski argued that there was absolutely no substitute for a proper controlled trial of the treatment of symptomless hypertension as there remained considerable doubts as to its value. In that year, I was a medical student at The London Hospital in Whitechapel. I was attached to the clinical ‘firm’ of a consultant physician whose name had better be withheld. He taught us that there was no evidence that symptomless hypertension was worth treating and furthermore decreed that none of his patients were to receive antihypertensive drugs. It was rumoured, however, that his patients actually had two treatment cards. One treatment card was the one that he saw himself where antihypertensive drugs were not included. The other treatment card, which was withheld from him, was used by the doctors and nurses attached to his department, and here antihypertensive drugs were prescribed.

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References

  1. Hamilton M, Thompson EN, Wisniewski TKM . The role of blood pressure control in preventing complications of hypertension. Lancet 1964; i: 235–238.

    Article  Google Scholar 

  2. Smirk FH, Hamilton M, McQueen EG, Doyle AE . The treatment of hypertensive heart failure and of hypertensive cardiac overload by blood pressure reduction. Am J Cardiol 1958; 1: 143.

    Article  CAS  Google Scholar 

  3. Leishman AWD . Hypertension—treated and untreated. BMJ 1961; 1: 1–5.

    Article  Google Scholar 

  4. Veterans Administration Cooperation Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension. JAMA 1967; 202: 1028–1034.

  5. Hypertension Detection Follow-up Program Cooperative Group. Five year findings of the Hypertension Detection and Follow-up Program. I. Reduction in mortality of patients with high blood pressure, including mild hypertension. JAMA 1979; 242: 2562–2571.

  6. Australian National Blood Pressure Management Committee. The Australian therapeutic trial in mild hypertension. Lancet 1980; i: 1261–1267.

  7. Medical Research Council Working Party. MRC trial of treatment of Mild Hypertension. BMJ 1985; 291: 97–104.

  8. Bulpitt CJ, et al., Hypertension in the Very Elderly Trial Working Group. Results of the pilot study for the Hypertension in the Very Elderly Trial. J Hypertens 2003; 21: 2409–2417.

    Article  CAS  Google Scholar 

  9. Poulter NR . Prospects for hypertension in the next decade. Br J Cardiol 2003; 10: 918–920.

    Google Scholar 

  10. Guidelines Subcommittee. 1999 World Health Organization—International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17: 151–183.

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  1. University Department of Medicine, City Hospital, Birmingham, UK

    D G Beevers

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  1. D G Beevers
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Correspondence to D G Beevers.

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Beevers, D. The 40th anniversary of the publication in 1964 of the first trial of the treatment of uncomplicated, severe hypertension by Hamilton, Thompson and Wisniewski. J Hum Hypertens 18, 831–833 (2004). https://doi.org/10.1038/sj.jhh.1001783

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