In a questionnaire-assessed first-degree family history of hypertension obtained in a sizable subsample of middle-aged male attenders to a multiphasic health screening programme in Malmö, the actual blood pressure distributions and other risk factors are compared in the different heredity groups. Both mean values and frequencies of borderline and hypertensive levels of the systolic and diastolic blood pressures were significantly higher in groups with a family history of hypertension in particular biparental, than in those without. Reported paternal hypertension was less frequent than reported maternal hypertension but resembled more the biparental history group in terms of the recorded blood pressure levels. Several biochemical and physiological variables were compared between the groups, but there were no differences in associated risk factors, including blood lipids, except for higher serum urate in the biparental history group than in the others. Only part of the overrepresentation of increased blood pressure levels that was present appeared to be of the genuine idiopathic variety of hypertension, and the genotype for this disorder did not appear to be associated with other risk factors for hypertension in the population.
Among the first screened 2439 males born in 1926 and 1927, aged 48-49 years at the time of screening and representing 76% of these age cohorts, uncontrolled or partly controlled hypertension was found in 7.5%. Of these individuals, 30% preferred to remain with their physicians, regardless of the degree of control they had achieved. Among those who were referred to the Hypertension Unit (5.2% of the screened population), elevated S-GT levels (greater than or equal to 1.10 mukat/l) were found in 38.3%, against 18.5% in the two cohorts. During 24 months of treatment and follow-up only two men among the entire group of hypertensives referred dropped out, both were heavy drinkers (greater than 80 g alcohol daily). The mean BP after treatment was significantly lower among men with normal than high S-GT values or in those who admitted to heavy drinking. Of the 99 males treated for more than two years, 82 (83%) were responders (supine DBP less than or equal to 95 mmHg). Of the non-responders, 70% were either heavy drinkers or had abnormal S-GT values. The possible role of alcohol in the pathogenesis of essential hypertension in middle-aged males is discussed.
Carboxyhemoglobin (COHb%) and gamma-glutamyl-transferase (GGT) are indicators of tobacco and alcohol consumption; similarly, body weight broadly reflects dietary habits. Relationships between COHb%, GGT, relative body weight, heart rate and blood pressure were studied in 242 48-year-old men attending a general health screening program in Malmö, Sweden. All were without treatment for high blood pressure. Positive correlations were found between blood pressure and body weight, GGT, and pulse, and a reciprocal correlation between blood pressure and COHb%. Use of objective markers for known or suspected risk factors, such as alcohol consumption, smoking, or overweight, were studied to elucidate their usefulness for further prospective studies.
A report is given from an on-going multicenter trial in Sweden, in which 117 hypertensive patients have been treated with a new cardioselective beta-adrenergic blocking agent, atenolol (ICI 66.082, Tenormin) for an average of six months (range 2-21). Statistically significant reductions of BP were observed, recumbent by 29/19 mmHg (p less than 0.0001) and standing by 28/18 mmHg (p less than 0.0001). Few and comparatively mild side-effects were seen.
A self-reported first-degree family history of hypertension was obtained by questionnaire in two consecutive subsamples of middle-aged male attenders to a multi-phased health screening program in Malmö. This corresponded to 2739 men in lower (36-39 years) and 6597 in upper (46-48 years) middle age. Reported first-degree family history of hypertension was very frequent, about 26-27% in both groups. It was predominantly confined to the parental generation and was twice as common in mother as in father. Furthermore, the reported family histories showed marked interrelations. Thus, hypertension was much more frequently reported when both parents had the condition than if it only concerned one of them. It is proposed that these findings may reflect an increased awareness, investigation, diagnosis and treatment of hypertension rather than the genetic occurrence of the disease per se in modern society.