Predicting Death From Renal Failure in Primary Hypertension

After a retrospective study of 174 individuals who died from chronic primary hypertension, it was found that prediction of death from renal failure could be quantitated on the basis of initial measurement of the systolic blood pressure, cardiac-thoracic ratio, blood urea, and age at the time of initial diagnosis. The group with renal failure had massive cardiomegaly and very contracted kidneys. One half of the population was Negro, but the natural history of their hypertension was not convincingly different from the white group. If initial clinical observations are substituted in the discriminant equation, D=-1.5(age at onset) + 3(percent cardiac-thoracic ratio) + 0.5(systolic blood pressure) + 1(blood urea), and D is greater than 249, 85% of patients died of renal failure. If D is less than 249, 85% of patients died of causes other than renal failure.