A 5-year follow-up of preventive approach to patients with essential hypertension.

We examined the effect of a 4-5 week spa programme consisting of hypertension control education, physical education and smoking cessation on a long-term risk factor control. Two hundred and twenty hypertensive males underwent a 1 month training programme. At the end of the month, improvement had occurred in blood pressure (BP), heart rate (HR) exercise capacity, degree of obesity and serum cholesterol and triglycerides. At 5-year follow-up several parameters still showed improvement. The mean resting, exercise and recovery BP was lower than initial values as was the double product. The subjective and objective load tolerance during exercise had also improved. Half of the patients required less medication than initially to control their BP and in 80% of cases the BP was either the same or lower than initially. The mean heart size did not change from control values; 84% of patients felt that their general health improved. The mean triglyceride level was lower than at the start and the number of smokers had fallen from 33 to 21%. On the other hand several parameters showed disappointing results. The weight and serum cholesterol and risk factor score remained unchanged and mean resting HR actually increased. Only 10% were exercising regularly and 20% had a worsening of their BP. Thus intensive short term intervention studies may help reduce some cardiovascular risk factors temporarily but the long effect of this intervention in the control of risk factors is still limited.