Biomedical subjects

M Beevers

Publications and source records attributed to M Beevers.

47 records · Page 3Linked to original sources

PubMed1986

Lack of difference between malignant and accelerated hypertension.

The clinical features and survival rates of 200 consecutive patients with malignant and accelerated hypertension admitted to a district hospital were investigated. Ninety five patients had bilateral haemorrhages and exudates and papilloedema (grade IV retinopathy) and 31 had bilateral haemorrhages and exudates with no papilloedema (grade III). A further 74 patients had bilateral retinopathy but failed to meet the criteria for grade IV or III and were investigated separately. No overall differences were found in survival when comparing the various grades of retinopathy. Cigarette smoking was significantly commoner only in grade IV patients compared with those with non-malignant hypertension matched for age, sex, and race. In patients with grade III retinopathy excess smoking was not statistically significant. In conclusion, the clinical features and survival rate showed that malignant and accelerated hypertension are one and the same disease.

Female↗

PubMed1986

An audit of nifedipine in a hypertension clinic.

The results of treating 235 hypertensive patients who had been prescribed nifedipine in a hypertension clinic were examined for factors affecting blood pressure response and the frequency of side-effects. Pretreatment systolic and diastolic blood pressure correlated significantly with the decrease in blood pressure but this effect was lost following statistical correction. No relation was found between response and age or race nor did any biochemical or haematological parameter predict the antihypertensive effect. Fifty-nine (25%) patients complained of side-effects which were dose related; the drug had to be discontinued in 30 patients (13%) but the remaining 29 continued at the same or reduced dosage. Small, but statistically significant, elevations were seen in serum albumin, alkaline phosphatase and bilirubin as well as a rise in average blood glucose levels. Although side-effects are fairly common nifedipine is an effective antihypertensive drug when given alone or in combination with other therapies.

Age Factors↗

PubMed1985

Similarity of blood pressure in blacks, whites and Asians in England: the Birmingham Factory Study.

Factory workers aged 16-64 years were screened for ethnic differences in blood pressure. The 78% response rate was evenly spread between whites (439 men; 164 women), black West Indians (173 men; 101 women) and Asians (172 men). Mean systolic and diastolic pressures by age decade in men were similar in all three groups, but there was a modest excess of both higher and lower blood pressures in blacks and Asians. Older black women had higher blood pressures than whites, but body mass indices were 2-5 kg/m2 greater. Multiple regression analysis revealed no significant effect of ethnic group on either systolic or diastolic blood pressure variance and that the higher pressures in black women were accounted for by differences in age and body mass index. The influence of body mass index was more marked on diastolic than systolic pressure. In men, alcohol intake and a family history of hypertension had small independent positive effects on systolic pressure. The lack of black/white difference in blood pressure differs from the United States results and may be due to the similarity in social class of participants. This should be confirmed in further population samples with larger numbers of black (and Asian) subjects.

Adolescent↗

PubMed1985

Prevalence of hypertension in white, black and Asian diabetics in a district hospital diabetic clinic.

In a District General Hospital Diabetic Clinic 40.0% of a random sample of diabetics under the age of 65 years of age were hypertensive. Black patients (48.9%) had greater (p less than 0.05) prevalence of hypertension than Whites (37.5%) and Asians (35.4%). Hypertension was more prevalent in females (49.1%) than males (33.0%) (p less than 0.001) in each ethnic group except Asians, and patients not receiving insulin had greater prevalence (45.6%) than those on insulin (30.7%) (p less than 0.001), except black diabetics where the reverse was found. There was a positive relationship between age and systolic (p less than 0.00001) and diastolic blood pressure (p less than 0.00001) and a negative association between duration of diabetes and diastolic blood pressure (p less than 0.004) on multiple regression analysis but no relationship was noted between blood pressure and either weight or blood glucose. Forty-six percent of all hypertensives were receiving conventional anti-hypertensive drug therapy; 38.7% were normotensive with similar results in each ethnic group and between the sexes. Isolated systolic hypertension was the commonest form of hypertension (48.3%) with isolated diastolic hypertension (4.9%) the rarest. These findings were observed regardless of the ethnic group or gender. Although in the majority of cases hypertension was mild these data confirm the importance of routine blood pressure measurement in diabetic patients.

Cross-Sectional Studies↗

PubMed1984

Standardized methods for comparison of sphygmomanometers.

Medical research in general and equipment comparisons in particular suffer from a deficiency and disparity of statistical analysis. We studied four semi-automatic sphygmomanometers in comparison with the Hawksley random zero mercury manometer. The Astropulse 80 showed marked deviation from the standard machine in average blood pressure recorded and greater variation of readings. The Infrasonde M3010, Bosomat II and Infrasonde D4000 were similar to the standard machine. To help comparability in future studies we suggest the following guidelines; blood pressures to be taken under standard conditions, data to be shown as scatterplots, analysis of variance to be performed and regression analysis to be used only to give an approximate overall view. Finally, we urge the manufacturing companies to conduct such studies and include the results in their brochures.

Blood Pressure Determination↗

PubMed1983

Blood pressure in black, white and Asian factory workers in Birmingham.

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.

Adolescent↗

PubMed1983

The Birmingham blood pressure school study.

Four-hundred and twenty-eight school leavers of 3 ethnic groups (white, black and Asian) were screened for blood pressure, resting pulse rate and general anthropometric characteristics. Asian pupils were both shorter and lighter than the other two groups whilst black males were heavier and taller. There was no significant difference in the mean systolic or diastolic blood pressure between the 3 groups, although the black pupils had a stronger family history of hypertension, particularly on the mother's side. These observations differ in some respects from other ethnic blood pressure studies and establish values for the local population.

Adolescent↗

PubMed1983

The ethnic prevalence of hypertension in a diabetic clinic.

Using the WHO criteria of hypertension, we have demonstrated that 40% of randomly selected diabetic clinic attenders under the age of 65 were hypertensive. Black diabetics had a significantly greater prevalence (P less than 0.001) of hypertension than either white or Asian diabetics. Hypertension was commoner in black and white females compared with males (P less than 0.001); in Asians this difference was not statistically significant. Systolic hypertension was the most common form in all ethnic groups. Only 38.7% of diabetics receiving antihypertensive therapy had normal blood pressure readings. Blood pressure measurement should therefore be routinely performed in all diabetic patients under the age of 65, particularly in females of all ethnic groups and in black males.

Adult↗

PubMed1983

The effects of a high fibre, low fat and low sodium dietary regime on diabetic hypertensive patients of different ethnic groups.

Fifty-three diabetic patients with mild hypertension were allocated to a treatment diet with a high fibre, low fat and low sodium dietary regime or a control diet. After a 1-month treatment period, the modified-diet treated group (n = 35) showed a highly significant reduction in mean diastolic blood pressure (P less than 0.001) accompanied by significant reduction in urinary sodium excretion (P less than 0.01). The mean values of diastolic pressure (P less than 0.05) and urinary sodium/potassium ratio (P less than 0.01) were also significantly reduced at 1 month compared to control. White (n = 16) and West Indian (n = 10) diabetic hypertensive patients demonstrated a similar significant hypotensive response (P less than 0.05 and less than 0.01 respectively) with reduction in urinary sodium excretion to the modified diet. In contrast, Asian patients demonstrated no significant changes. Treatment of hypertension in diabetic subjects with a high fibre, low fat and low sodium dietary regimen may have a hypotensive response after a period of 1 month and there is a similar response in both black and white ethnic groups. Further observation of these patients will determine long-term response and compliance.

Adult↗

PubMedDate not supplied

Clinical evaluation of the Copal UA-251 and the Dinamap 1848 automatic blood-pressure monitors.

The Copal UA-251 is a small automatic blood-pressure monitor, which relies on a piezo-electric microphone for detection of Korotkoff sounds. The Dinamap 1848 automatic monitor uses the oscillometric method for blood-pressure determination. When compared with the Hawksley random-zero sphygmomanometer, the Copal UA-251 recorded higher systolic blood-pressure, with this discrepancy widening at the upper end of the systolic pressure range. The agreement between these machines was reasonable for diastolic blood-pressure. The Dinamap 1848 had a tendency to consistently over-read systolic and under-read diastolic blood-pressure compared with the Hawksley sphygmomanometer, with median differences of 7 mmHg and -2.5 mmHg respectively.

Blood Pressure Determination↗

PubMedDate not supplied

Do clinicians prescribe HRT for hypertensive postmenopausal women?

Despite the benefits of hormone replacement therapy (HRT) in relieving menopausal symptoms, there continues to be anxiety about its use in women who also have hypertension. To examine clinical practice in relation to HRT, especially in patients with hypertension, and to canvass opinions on potential or perceived side-effects, the authors conducted a postal survey of HRT prescribing habits among 285 GPs, physicians and obstetricians in the West Midlands. The overall response rate to the questionnaire was 191 (66.3%): 61 clinicians reported that they would not prescribe HRT in women whose hypertension was difficult to control, but only 3 would withhold treatment if blood pressure was well controlled; 9% of physicians and 13% of gynaecologists did not routinely measure blood pressure before starting HRT or monitor BP at follow-up (24% and 10% respectively). A proportion of GPs (20%), physicians (21%) and gynaecologists (9%) reported that in their opinion HRT raised blood pressure, and a minority in each group considered that HRT increased the risk of venous thrombosis, stroke and myocardial infarction. This study demonstrates differences among GPs, physicians and gynaecologists in the use of HRT in menopausal women with hypertension, the authors suggest that, in view of data from studies of the effects of HRT on blood pressure and the possible reduction of cardiovascular disease, these clinicians can be reassured and hypertensive women need not be denied the benefits of HRT, as long as there is careful monitoring.

Attitude of Health Personnel↗