patients who lived in urban areas and had known hypertension.这句话中为什么用had known表示“诊断为，不需要加be吗？

had hypertension. 患有高血压病。known为hypertension的定语，已知的。并非hand known过去完成时态，与被动语态也无关。

逻辑、逻辑、逻辑！！！