Management of rheumatic fever: a review.
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Biomedical subjects
Publications and source records attributed to B W Christmas.
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Two years after a hypertension screening survey conducted at Napier in 1973 the blood pressure levels of 350 adults were re-examined. The sample comprised 152 persons previously referred for investigation because of high blood pressure detected during the 1973 survey, a matched control group of 146 normotensives and a small supplementary control group. Of the 152 persons in the referred group 31 (20.4%) were under medical supervision at the time of the 1973 survey, 89 (58.5%) attended a doctor within the next 12 months and 32 (21.1%) took no further action. Two years later the 31 cases previously under medical supervision had remained on therapy but only 43 of the 89 new cases were receiving treatment at the time of re-examination. More than 50% of the cases in the referred group showed a decrease in the mean systolic pressure of 10mmHg or greater over the two-year period compared with 20.5% of the normotensive control group. Only 32% of referred cases were regarded as effectively controlled at the time of re-examination ie had mean systolic pressures less than 160mmHg and mean diastolic pressures less than 95mmHg. The low level of effective control resulting from the earlier survey casts further doubt on the value of mass screening procedures for hypertension.
The prevalence of hypertensive levels of blood pressure was investigated in a random sample of 2535 adults in Napier in 1973. More than 70 percent of all persons examined had been measured for blood pressure within the previous five years. A retrospective analysis of results using the WHO classification indicated that 16.4 percent of the adult population had a mean systolic pressure of not less than 160mmHg or mean diastolic pressure of not less than 95mmHg. One third of the hypertensive group was receiving treatment and one half of those on therapy were effectively controlled. The total prevalence of treated and untreated hypertensives was estimated to be 20 percent of the survey population. According to the WHO criteria for blood pressure classification 33 percent of those over 60 years were hypertensive.
Ninety-seven percent of a randomly selected sample of 2600 adults (age range 21 to 92 years) from the Napier City electoral area were surveyed for age and sex distribution of blood pressure. The sample included those currently receiving drug treatment for elevated pressures. There were approximately 400 in each decade and the sex ratio slightly favoured females. Casual systolic pressures rose with age whereas the diastolic rose to approximately age 50 and thereafter remained steady or slightly declined. Before age 50 years males had higher systolic pressures than females and thereafter the mean levels for females exceeded those for the males. Mean systolic pressures for this New Zealand sample population were higher by 2-4mmHg for all ages than the levels reported for the United States National Health Survey 1960-62.
A second survey of New Zealand doctors' smoking habits in 1972 elicited an 83 percent response from 3113 doctors. 38.5 percent had never smoked compared with 23.8 percent in a 1963 survey; 29.2 had given up smoking, and 33.3 percent still smoked. Only 21.3 percent smoked cigarettes compared with 35.3 percent in 1963. There has been a sustantial increase in non-smokers among recent graduates. Both sexes now smoke cigarettes less frequently but pipe and cigar smoking by male doctors has risen sharply. Obstetricians smoke cigarettes more often than other groups of doctors, while pathologists, medical administrators and academics smoke the least. Giving up smoking was not difficult for most former smokers except for the heavy smokers who now make up most of the persistent smoker group.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.