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Community-wide surveillance of strokes associated with high blood pressure
422
ABSTRACTS: HIGH BLOOD PRESSURE CONTROL
involvement (FI) with self-blood pressure monitoring (SBPM) or to a fifth other-provider control group. Analyses of blood pressure data midway through the experiment reveal a significant interaction effect between FI and SBPM, but no main effects. An identical significant interaction effect was obtained on two independently obtained blood pressure data sets, thereby reducing the probability of this being a chance finding. Data on the characteristics of family structure, i.e., husband-wife interaction, conjugal division of tasks, conjugal power, which previous research has shown to be related to health promoting behaviors, has also been collected (June, 1979). This paper will present the relationships among these family structural characteristics, measures of compliance with medical regimes, and blood pressures from midway through the experiment.
A-6 Community-wide
Surveillance
of Strokes Associated with High Blood Pressure. WILLIAM
BARKER,
University of Rochester School of Medicine, 601 Elmwood Avenue, Rochester, New York 14642; KAREN FELDT; JOHN FEIBEL. High blood pressure (HBP) is the commonest treatable risk factor for stroke (CVA). Accordingly, the effectiveness with which detection and treatment of HBP have been applied in a general population is being assessedby a community-wide CVA surveillance project begun in 1979 in Monroe County, N.Y. All new hospitalized cases are included. Each case is assessed through interview and medical record review for evidence of HBP, HBP medication use, HBP control status, and patterns of medical care provided prior to onset of CVA. Data is also being collected on other CVA risk factors. Among 155 cases assessed to date, 45% were under 70 years old, 52% were males, and proportions with selected risk factors were as follows: HBP (&I%), heart disease (58%), diabetes (24%), T.I.A. (32%), obesity (40%), smoking (45%). All cases with HBP are being further investigated to ascertain whether improvement in HBP detection or management, in the presence of the patient’s other risk factors, might have prevented the CVA. This project is presented as a model outcome-based system for monitoring effectiveness with which high-risk HBP patients in a community are being found and treated. Current findings and practical aspects will be discussed.
A-7 Effect of Placebo Therapy on Blood Pressure. JOHN H. BAUER, Truman Memorial Veterans Hospital
& Department of Medicine, University of Missouri Medical Center, Columbia, Missouri 65201; REBECCA N. BURCH;
NAOMI
MAGLIOLA;
CHARLES S. BROOKS.
To assess the effect of placebo on blood pressure (BP) in hypertensive men, 45 adult hypertensive men off drug therapy for l-3 weeks underwent placebo treatment for an additional 3 weeks. Casual BP and heart rate (HR) were recorded in triplicate at half-hour intervals on Days 0, 7, 14, and 21 of placebo therapy, following 5-min recumbency, 2-min upright posture, and a single postexercise determination. Basal BP and HR were recorded on Day 22 following overnight recumbency. Results (mean _t SEM) are indicated below: Position RecumbentBP RecumbentHR Upright BP Upright HR
Day 0
Day 7
159 + 3/108 2 1 76 f 1 165 + 3/116 + 1
155 f 3*/106 + l* 75 * 1 160 f 3*/113 f 1*
Day 14
157 k 3/107 + 75 k 1 161 k 3/114 + 80 + 1 81 f 1 81 + 1 Exercise BP 174 e 3/109 + I 167 k 3*/105 + l* 163 + 4/106 k 91 + 2 Exercise HR 9Ok2 90+2 (*I’ < 0.025 compared to Day 0; ** P < 0.05 compared to Day 7; t P i
Day 21
Day 22
1
155 + 2/104 -t l** 149 k 3t/lOl f It 77 ir 1** 71 ? 1t 1 159 k 2/111 k l** 86 + 2** 1 159 k 3/ 99 + 2** 98 -c 2** 0.005 compared to Day 21.)
q
There were significant reductions (P < 0.025) in systolic and diastolic BP in all positions on Day 7 compared to Day 0. There were no significant changes in HR. There were significant reductions (P <
ABSTRACTS: HIGH BLOOD PRESSURE CONTROL
involvement (FI) with self-blood pressure monitoring (SBPM) or to a fifth other-provider control group. Analyses of blood pressure data midway through the experiment reveal a significant interaction effect between FI and SBPM, but no main effects. An identical significant interaction effect was obtained on two independently obtained blood pressure data sets, thereby reducing the probability of this being a chance finding. Data on the characteristics of family structure, i.e., husband-wife interaction, conjugal division of tasks, conjugal power, which previous research has shown to be related to health promoting behaviors, has also been collected (June, 1979). This paper will present the relationships among these family structural characteristics, measures of compliance with medical regimes, and blood pressures from midway through the experiment.
A-6 Community-wide
Surveillance
of Strokes Associated with High Blood Pressure. WILLIAM
BARKER,
University of Rochester School of Medicine, 601 Elmwood Avenue, Rochester, New York 14642; KAREN FELDT; JOHN FEIBEL. High blood pressure (HBP) is the commonest treatable risk factor for stroke (CVA). Accordingly, the effectiveness with which detection and treatment of HBP have been applied in a general population is being assessedby a community-wide CVA surveillance project begun in 1979 in Monroe County, N.Y. All new hospitalized cases are included. Each case is assessed through interview and medical record review for evidence of HBP, HBP medication use, HBP control status, and patterns of medical care provided prior to onset of CVA. Data is also being collected on other CVA risk factors. Among 155 cases assessed to date, 45% were under 70 years old, 52% were males, and proportions with selected risk factors were as follows: HBP (&I%), heart disease (58%), diabetes (24%), T.I.A. (32%), obesity (40%), smoking (45%). All cases with HBP are being further investigated to ascertain whether improvement in HBP detection or management, in the presence of the patient’s other risk factors, might have prevented the CVA. This project is presented as a model outcome-based system for monitoring effectiveness with which high-risk HBP patients in a community are being found and treated. Current findings and practical aspects will be discussed.
A-7 Effect of Placebo Therapy on Blood Pressure. JOHN H. BAUER, Truman Memorial Veterans Hospital
& Department of Medicine, University of Missouri Medical Center, Columbia, Missouri 65201; REBECCA N. BURCH;
NAOMI
MAGLIOLA;
CHARLES S. BROOKS.
To assess the effect of placebo on blood pressure (BP) in hypertensive men, 45 adult hypertensive men off drug therapy for l-3 weeks underwent placebo treatment for an additional 3 weeks. Casual BP and heart rate (HR) were recorded in triplicate at half-hour intervals on Days 0, 7, 14, and 21 of placebo therapy, following 5-min recumbency, 2-min upright posture, and a single postexercise determination. Basal BP and HR were recorded on Day 22 following overnight recumbency. Results (mean _t SEM) are indicated below: Position RecumbentBP RecumbentHR Upright BP Upright HR
Day 0
Day 7
159 + 3/108 2 1 76 f 1 165 + 3/116 + 1
155 f 3*/106 + l* 75 * 1 160 f 3*/113 f 1*
Day 14
157 k 3/107 + 75 k 1 161 k 3/114 + 80 + 1 81 f 1 81 + 1 Exercise BP 174 e 3/109 + I 167 k 3*/105 + l* 163 + 4/106 k 91 + 2 Exercise HR 9Ok2 90+2 (*I’ < 0.025 compared to Day 0; ** P < 0.05 compared to Day 7; t P i
Day 21
Day 22
1
155 + 2/104 -t l** 149 k 3t/lOl f It 77 ir 1** 71 ? 1t 1 159 k 2/111 k l** 86 + 2** 1 159 k 3/ 99 + 2** 98 -c 2** 0.005 compared to Day 21.)
q
There were significant reductions (P < 0.025) in systolic and diastolic BP in all positions on Day 7 compared to Day 0. There were no significant changes in HR. There were significant reductions (P <