A 1-year double-blind placebo-controlled study on the effects of diuretic withdrawal was conducted on a group of 62 previously well-controlled, mildly hypertensive patients. Data were collected on blood pressure (BP), biochemical laboratory values, and subjective reports of side-effects. Twenty-six percent of placebo subjects and 3% of the active treatment subjects reached preset criteria for the return of hypertension (reverters). The average systolic and diastolic pressures of all placebo-treated patients who did not revert showed statistically significant increases. BP control was quickly reestablished in reverters by restarting diuretic therapy. No substantial differences in side-effects were reported between the groups, and laboratory changes were those consistent with known metabolic effects of thiazide and thiazide-like diuretics. This study showed a much lower reversion rate after treatment withdrawal than previously reported by other investigators. It also showed significant increases in BP of placebo patients who did not revert. Long-term diuretic therapy retains its effectiveness in responsive mild hypertensive patients, potentially offering protection against the increased risks of mortality and morbidity associated with even slight elevations of BP. Withdrawal of diuretics cannot be recommended for patients with mild hypertension without use of other equally effective interventions to maintain optimum BP control.

Adult↗

PubMedDate not supplied

Hypertension detection and follow-up program. Baseline electrocardiographic characteristics of the hypertensive participants.

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Adult↗

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The subjective aspects of coronary care.

An exit questionnaire to measure satisfaction with selected aspects of coronary care was given to patients following discharge from coronary care units in 11 community hospitals in the Intermountain West. Although overall satisfaction was found to be high, the responses indicated significant differences (p less than .01) in patient satisfaction among the dimensions examined. The central findings suggest the need for more attention to the nontechnical aspects of care, especially reduction of emotional trauman and improved interpersonal relations. Practical implicattions of these and other findings for the nursing profession as well as for coronary care are discussed.

Communication↗

PubMedDate not supplied

Successful modification of medical students' cardiovascular risk factors.

Modifying identified risk factors for cardiovascular disease should change an individual's risk. Educational interventions might change behavior to modify some risk factors. To evaluate this possibility, we evaluated the health and fitness status of freshman medical students at the University of Utah (n = 89) in 1983 and determined their cardiovascular risk factors. During a preventive cardiology course later that year, students received their results. We reevaluated the students during their senior year using the same method. For both years, we obtained complete data on 77 (87%) of the eligible students. As freshmen 83% of these students had at least one modifiable risk factor, compared with 62% with a risk as seniors. The number of reevaluated students with low levels of high-density lipoprotein cholesterol, low estimations of aerobic capacity, or both, decreased significantly (P = .009 and P = .0008, respectively). The preventive cardiology educational intervention may have changed behavior and improved cardiovascular risk factors.

Adolescent↗