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1.  A blood pressure clinic in a health centre. 
Postgraduate Medical Journal  1976;52(613):683-686.
Following a screening survey for hypertension in Renfrew, a blood pressure clinic was established in a health centre. Three hospital doctors, each working an average of two sessions weekly, saw 368 patients. A specially trained nurse played an important part in the running of the clinic. Attendance of patients was high, and defaulting amongst those needing treatment was low. Blood pressures were well controlled in 75% of the patients. The clinic has proved an acceptable method of managing large numbers of hypertensives without reference to hospital.
PMCID: PMC2496331  PMID: 1012994
3.  Blood pressure measurement at screening and in general practice. 
British Heart Journal  1977;39(1):7-12.
As part of an epidemiological study of hypertension, an analysis was made of the general practitioner records of all attenders at a screening survey. A blood pressure recording, made before screening, was found in 37-9 per cent of cases. The pressures obtained correlated well with those obtained by the screening unit, though the practitioners' readings tended to be lower. Further cases of hypertension were found, not diagnosed by the screening unit; the estimate made of the prevalence of hypertension at the survey could be corrected by inclusion of these cases. Chest pain, headaches, lightheadedness, and dizziness were common reasons for blood pressure measurement in general practice, but these symptoms were not associated with a rise in the blood pressure; symptoms were not helpful in the diagnosis of hypertension. Some form of screening programme is necessary to detect cases of hypertension. This could be carried out by general practitioners.
PMCID: PMC483186  PMID: 831740
4.  Rectal potential difference in the diagnosis of aldosterone excess. 
Gut  1975;16(1):36-41.
Rectal potential difference (pd) is directly related to the plasma aldosterone concentration, and rises when aldosterone is stimulated by sodium deprivation. However, when the measurement of rectal pd was tested at a screening test for hyperaldosteronism in 19 hypertensive subjects, four of the eight with primary hyperaldosteronism had a normal pd and four of the eight without aldosterone excess had an abnormally raised potential difference. The technique cannot therefore be recommended as a routine screening test for hyperaldosteronism. No relationship was found between rectal pd and hypertension associated with excess of deoxycorticosterone. Rectal pd rises in response to the mineralocorticoid-like agent carbenoxolone.
PMCID: PMC1410947  PMID: 237802
5.  The importance of good blood pressure control in the prevention of stroke recurrence in hypertensive patients 
Postgraduate Medical Journal  1981;57(673):690-693.
One hundred and twenty-four patients (70 men and 54 women) who were treated for hypertension after a stroke, between 1968 and 1976, were studied. Twenty-one (11 men and 10 women) developed a second stroke after a mean period of just over 2 years. The women who had a stroke recurrence had higher initial systolic and diastolic blood pressure (BP) as well as higher achieved BP. The men with recurrence had no significant difference in initial BP but had higher BP on treatment. Patients who achieved BP of <160 mmHg systolic or 90 mmHg diastolic had a low incidence of recurrent stroke. Good BP control in hypertensive patients prevents stroke recurrence but may be difficult to achieve.
PMCID: PMC2426208  PMID: 7339599
6.  Age, sex, ethnic origin and hospital admission for heart attack and stroke 
Postgraduate Medical Journal  1981;57(674):763-765.
The frequency of admission for heart attack and stroke in blacks, whites and Asians to Dudley Road Hospital, Birmingham, was studied. The study population (denominator) was 17 739 consecutive admissions to this hospital for the years 1975 to 1979, in 35- to 64-year-old men and women. Admission for heart attack was half as common in blacks compared with whites and, in some age groups, there was a slightly increased rate in Asians. By contrast, in both sexes and in all age groups, stroke admission was commoner in blacks. These differences cannot be explained by differing levels of blood pressure or cigarette smoking in the 3 ethnic groups.
PMCID: PMC2426266
7.  Total exchangeable potassium in response to amiloride. 
Postgraduate Medical Journal  1978;54(634):533-537.
The use of amiloride is described in twenty-four hypertensive patients who became hypokalaemic as a result of thiazide diuretic therapy in spite of oral potassium supplments. Amiloride caused a significant rise in exchangeable potassium, exchangeable potassium/kg body weight, and plasma potassium, together with a significant fall in plasma total carbon dioxide, body weight, systolic and diastolic blood pressures. These results suggest that amiloride has a useful role in this type of patient.
PMCID: PMC2425276  PMID: 733684
8.  A comparison of hospital and general practice blood pressure readings using a shared-care record card 
Shared-care blood pressure record cards were issued to 149 consecutive hypertensive patients attending our hospital clinic. In 108 (72.5 per cent), general practitioners entered readings they had obtained onto the cards. The use of the record card has proved helpful in the management of patients, and we are encouraged by the co-operation of the family doctors.
A comparison of blood pressures measured in hospital and in general practice showed that general practitioners found systolic pressures to be an average of 5.5 mm Hg lower than hospital doctors, but there were no differences in diastolic pressure. In many cases, wide discrepancies were found both in hospital and general practice. We conclude that it is a myth that patients' blood pressures are lower when they consult their family doctor, or that outpatient blood pressure readings are falsely elevated by the stress of hospital attendance.
PMCID: PMC1972038  PMID: 7299728
9.  Hypertension in aortic valve disease and its response to valve replacement. 
Postgraduate Medical Journal  1992;68(797):180-185.
We have investigated the prevalence of hypertension and the response of blood pressure to operation in 87 patients with lone aortic valve disease who underwent aortic valve replacement. In patients with aortic stenosis alone 26% were hypertensive pre-operatively (age and sex adjusted blood pressure greater than 160 systolic and or greater than 95 mmHg diastolic) and 24% were hypertensive post-operatively. In those with aortic regurgitation alone, hypertension was present in 65% before and 57% after valve replacement using the same criterion. For combined stenosis and regurgitation, the prevalence was 54% and 62%, respectively. The post-operative increase in systolic pressure in patients with aortic stenosis occurred mainly in those with a history of left ventricular failure. In those with aortic regurgitation or combined stenosis with regurgitation, diastolic pressure rose after valve replacement resulting in a prevalence of diastolic hypertension of 44% and 35%, respectively. Blood pressure changes were not predicted by the type of valve inserted nor its size. Our data show that despite severe symptomatic aortic valve disease, systolic hypertension was common in aortic stenosis and diastolic hypertension was found in aortic regurgitation. This underlines the importance of blood pressure monitoring in patients following aortic valve replacement.
PMCID: PMC2399236  PMID: 1589375
11.  Hypertension. 
Postgraduate Medical Journal  1991;67(785):230-246.
PMCID: PMC2399022  PMID: 2062770
12.  Blood Pressure in a Scottish Town 
British Medical Journal  1974;3(5931):600-603.
As part of a general health screening survey in the Burgh of Renfrew blood pressure was measured in 3,001 subjects (78·8% of those eligible) aged 45 to 64. In 468 (15·6%) diastolic blood pressure was 100 mm Hg or more. A year later the mean blood pressure for those of the population re-examined showed no change, there being an equal number of subjects with increased and decreased pressures. The prognostic significance of those showing the larger fluctuations remains to be determined through medical-record linkage.
Examination of the general practitioners' medical records of 422 of the 468 subjects with diastolic blood pressure of 100 mm Hg or more showed that 255 had no previous documented hypertension. Of the remainder 73 were receiving antihypertensive therapy. Examination of the records of subjects whose blood pressure was under 100 mm Hg showed that 55 were receiving antihypertensive treatment and that another 113 had previously been recorded as having a diastolic blood pressure of 100 mm Hg or more by their general practitioner. Altogether at least 636 (21·2%) of those who were examined had been considered at some time to have evidence of hypertension.
The prevalence of undetected hypertension in the general population has important implications for the resources of the National Health Service if current trials show benefit to the health of the community from treating “mild” as well as “moderate” hypertension.
PMCID: PMC1611630  PMID: 4418800
13.  Blood-pressure screening and supervision in general practice. 
British Medical Journal  1979;1(6167):843-846.
Since April 1975 all men aged 35-69 years registered with four general practices in west central Scotland have had their blood pressure checked whenever they visit the surgery. Although the practice locations range from rural to city centre and observers comprise receptionists, nurses, and doctors, a standard procedure has been adopted for the examination, recording, follow-up, and management of high blood pressure. The results confirm that raised blood pressure is common and often goes undetected. Even when hypertension is known, casual blood pressure readings often exceed accepted normal levels. The findings also show that a population may be routinely examined through normal contact with the family doctor, and that this can provide a convenient, acceptable, and effective means of detecting and reducing raised blood pressure.
PMCID: PMC1598536  PMID: 435839
14.  Pseudo-phaeochromocytoma due to alcohol withdrawal. 
Postgraduate Medical Journal  1985;61(718):721-723.
Alcohol withdrawal hypertension is a common clinical problem which often goes unrecognized. We report a case in which the symptoms and signs of withdrawal with a marked elevation in blood pressure mimicked the features of a phaeochromocytoma. Despite a positive phentolamine test no further evidence for phaeochromocytoma was found and both blood pressure and symptoms settled as the features of alcohol withdrawal abated.
PMCID: PMC2418363  PMID: 4034462
15.  Clinical evaluation of the Infrasonde D4000 blood pressure monitor. 
Postgraduate Medical Journal  1985;61(714):321-323.
Choosing a blood pressure machine from their ever increasing number is often difficult due to lack of performance data. We have evaluated a new automated non-invasive blood pressure recorder, the Infrasonde D4000. In comparison with the Hawksley random zero mercury sphygmomanometer the Infrasonde showed less variability for both systolic and diastolic readings. However, it was found to record significantly lower mean systolic and diastolic pressures.
PMCID: PMC2418217  PMID: 4022862
16.  Ethnic differences in peak expiratory flow rate in Birmingham factory workers. 
Postgraduate Medical Journal  1983;59(696):671-673.
Among 698 Birmingham factory workers, Asian men (n = 75) tended to have lower peak expiratory flow rates (PEFR) than black (n = 156) or white (n = 138) men when age, height and smoking habits were accounted for. This trend reached statistical significance in Asian females (n = 20), despite a small sample size. There were no significant differences in PEFR between blacks and whites of either sex.
PMCID: PMC2417654  PMID: 6647185
17.  Blood pressure in black, white and Asian factory workers in Birmingham. 
Postgraduate Medical Journal  1983;59(696):622-626.
A screening survey was conducted among factory workers, aged 15-64 years, in Birmingham, England to investigate ethnic differences in blood pressure. One-thousand and forty-nine subjects (784 men, 265 women) were screened, representing 79% of the eligible population. Mean systolic and diastolic blood pressures generally did not differ between men of black West Indian (n = 173), local white (n = 439) or Asian (n = 172) origin, when matched by 10-year age groups. Analysis of covariance using age as the covariate revealed that, overall, Asian men had significantly lower systolic but higher diastolic pressures than the other ethnic groups. The proportion of men arbitrarily defined as hypertensive (greater than or equal to 160 mmHg systolic or greater than or equal to 95 diastolic or blood pressures below this figure whilst receiving antihypertensive therapy) was 26% of West Indians, 22% of whites and 17% of Asians, but these were not significantly different when age was accounted for. Black West Indian women (n = 101) did have higher diastolic pressure than white women (n = 164), but this difference was dependent on body mass index. Overall, systolic pressures in women were not significantly different. These findings differ from those consistently reported from the United States.
PMCID: PMC2417647  PMID: 6647171
19.  Ethnic differences in respiratory disease 
Postgraduate Medical Journal  1981;57(674):777-778.
Hospital admission statistics from a district general hospital for patients aged 30-59 years over a 6-year period were analysed. There were 40 034 admissions excluding obstetrics. The overall distribution by place of birth was 9·2% West Indies, 13·5% Asia and 71·9% Northern Europe. This distribution was compared with the distributions for 4 groups of respiratory diseases. There were highly significant differences between these distributions for each diagnostic category. Asthma and respiratory tuberculosis were very much more common amongst Asians whilst West Indians suffered very little carcinoma of bronchus or bronchitis. Data collected from a factory screening showed that cigarette smoking could not account for these differences.
PMCID: PMC2426255
20.  Studies of red cell cation transport in white and black essential hypertensives 
Postgraduate Medical Journal  1981;57(674):769-771.
It has been reported previously in white patients with essential hypertension that red cell sodium pump activity as measured by ouabain-sensitive uptake of the potassium analogue 86Rb from a potassium-free medium, is very significantly greater than in white controls. In a further study of black (West Indian) subjects reported here no similar abnormality was present in black hypertensives when compared with black normotensive individuals. Red cell rubidium uptake was significantly lower in normotensive blacks than in normotensive whites although sodium pump activity was the same. These results may be relevant to observed racial differences in sodium handling and in the pathophysiology of essential hypertension.
PMCID: PMC2426254
21.  Comparison of the effects of single doses of atenolol and labetalol on airways obstruction in patients with hypertension and asthma. 
1 The effects of atenolol (100 mg), a cardioselective beta-adrenoceptor blocking agent, and labetalol (300 mg), a combined alpha- and non-selective beta-adrenoceptor blocking agent given in single doses were examined in a double-blind placebo controlled study in 11 asthmatic patients with hypertension. Changes in forced expiratory volume in one second (FEV1) were measured. 2 There were no significant differences between the effects of the active drugs, approximately half the patients having higher FEV1 values during each of the two active treatments. When compared with placebo, labetalol significantly reduced the effect of inhaled salbutamol on FEV1. 3 Whilst beta-adrenoceptor blockings drugs cannot be recommended in patients with airways obstruction, should they inadvertantly be given, labetalol like atenolol may be considered relatively safer then pure non-selective beta-adrenoceptor blocking drugs.
PMCID: PMC1427713  PMID: 6860529
24.  Salt and blood pressure in Scotland. 
British Medical Journal  1980;281(6241):641-642.
Dietary salt intake and urinary sodium excretion were compared in normotensive and hypertensive subjects in Renfrew, Scotland. All groups had high 24-hour urinary salt excretions, and hypertensive subjects did not eat or excrete more salt than normotensive subjects. The only significant relations found were a lower sodium excretion in hypertensive women than in normotensive women (p < 0.02) and a lower urinary sodium concentration in hypertensive men than in normotensive men (p < 0.05). These data provide no support for the hypothesis that dietary salt is a major cause of hypertension.
PMCID: PMC1714113  PMID: 7437746
25.  Divergent views of hospital staff on detecting and managing hypertension. 
British Medical Journal  1979;1(6165):715-716.
A questionnaire about detecting and managing hypertension was answered by 76 out of 110 (69%) doctors and 116 out of 195 (63%) qualified nurses in a large hospital. There was no general agreement on the method of taking diastolic blood pressures or on the level of hypertension requiring treatment. Most of the clinicians treated mild hypertension, although no proof exists that such treatment is beneficial. Almost everyone questioned agreed that measuring blood pressure in all patients attending hospital is important. Agreement should be reached, however, on which phase of diastolic blood pressure should be used.
PMCID: PMC1598866  PMID: 435747

Results 1-25 (97)