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The effect of auricular fibrillation on the course of hypertension
256
THE
AMKRICAN
HEART
JOURNAL
Ayman, David, and Goldshine, Archie D.: Cold as a Standard Pressure. New Englarld J. Med. 219: 630, 1938.
Stimulus
of Blood
The literature describing the use of the coldpressor test of Hines and Brown is critically reviewed. No study was found that had repeated the same technique as that of Hines and Brown in a group of patients with essential hypertension. The test, using the exact technique of Hines and Brown, was repeated in fortyeight subjects with normal blood pressure and eighty-eight subjects with essential hypertension. The results were in close agreement with those of Hines and Brown. The final significance of the excessive reactions in certain people with normal blood pressure will be known only after these subjects have been followed for a number of years in order to note how many develop true essential hypertension. For the present, the value of the cold test appears to lie in the field of investigation rather than in that of practical application. It is possihle, however, that it will eventually prove of real value in general practice to pick out many future candidates for essentiat hypertension or hypertension during pregnancy or those with past hypertension. NAIDE.
Rothstadt, L. E.: The Effect of Auricular tension. M. J. Australia 1: 813, 1938.
Fibrillation
on the Course of Hyper-
The frequency of auricular fibrillation in 1,000 cases of hypeltension uncomplicated l)y mitral stenosis was 7.3 per cent. Hypertension uncomplicated by mitral stenosis was present in 49 (or 11.2 per cent) of 435 cases of auricular fibrillation. Hypertension uncomplicated by mitral stenosis was present in 32 (or 33.7 per cent) of 94 patients who had had paroxysms of auricular fibrillation. A study was made of 50 patients with hypertension and established auricular fibrillation. All were between 45 and 75 years of age. Aurieular fibrillation is commoner in older than in younger patients with hypertension. The radiologic appearance.s are described and the difficulties in interpretation are discussed. Congestive heart failure and embolism were common sequelae. Eighty per cent of the deaths oeThe response to treatment was variable. curred within two years of the onset of fibrillation; but with treatment a patient might live for several years. Post-mortem appearances in seven pat,ients are described. and paroxysmal auricular fibrillation Thirty-six patients with hypertension were studied. The prognosis in hypertension with paroxysmal fibrillation is better than in hypertension with established fibrillation, other things being equal. Quinidine therapy often reduces the frequency of, or abolishes, the paroxysms. AUTHOR.
Kunkel, Paul, and Stead, Eugene A., Jr.: Blood Flow and Vasomotor Reactions in the Foot in Health, in Arteriosclerosis, and in Thromboangiitis Obliterans. J. Clin.
Investigation
17:
715, 1938.
Measurements of the blood flow in the foot in health, in arteriosclerosis, and in thromboangiitis obliterans were made under standard conditions by the plethysThe flow was recorded as cubic centimeters of blood per mographie method. minute per 100 cc. of tissue. The blood flow to the foot reached a constant level after thirty minutes at 43” C. The flow at this temperature has been designated as the “maximal” flow. The average maximal blood flow to the foot in normal persons was 17.1 c.e., with the highest 25.9 and the lowest Il.1 C.C. Ninety per cent of the flows were
THE
AMKRICAN
HEART
JOURNAL
Ayman, David, and Goldshine, Archie D.: Cold as a Standard Pressure. New Englarld J. Med. 219: 630, 1938.
Stimulus
of Blood
The literature describing the use of the coldpressor test of Hines and Brown is critically reviewed. No study was found that had repeated the same technique as that of Hines and Brown in a group of patients with essential hypertension. The test, using the exact technique of Hines and Brown, was repeated in fortyeight subjects with normal blood pressure and eighty-eight subjects with essential hypertension. The results were in close agreement with those of Hines and Brown. The final significance of the excessive reactions in certain people with normal blood pressure will be known only after these subjects have been followed for a number of years in order to note how many develop true essential hypertension. For the present, the value of the cold test appears to lie in the field of investigation rather than in that of practical application. It is possihle, however, that it will eventually prove of real value in general practice to pick out many future candidates for essentiat hypertension or hypertension during pregnancy or those with past hypertension. NAIDE.
Rothstadt, L. E.: The Effect of Auricular tension. M. J. Australia 1: 813, 1938.
Fibrillation
on the Course of Hyper-
The frequency of auricular fibrillation in 1,000 cases of hypeltension uncomplicated l)y mitral stenosis was 7.3 per cent. Hypertension uncomplicated by mitral stenosis was present in 49 (or 11.2 per cent) of 435 cases of auricular fibrillation. Hypertension uncomplicated by mitral stenosis was present in 32 (or 33.7 per cent) of 94 patients who had had paroxysms of auricular fibrillation. A study was made of 50 patients with hypertension and established auricular fibrillation. All were between 45 and 75 years of age. Aurieular fibrillation is commoner in older than in younger patients with hypertension. The radiologic appearance.s are described and the difficulties in interpretation are discussed. Congestive heart failure and embolism were common sequelae. Eighty per cent of the deaths oeThe response to treatment was variable. curred within two years of the onset of fibrillation; but with treatment a patient might live for several years. Post-mortem appearances in seven pat,ients are described. and paroxysmal auricular fibrillation Thirty-six patients with hypertension were studied. The prognosis in hypertension with paroxysmal fibrillation is better than in hypertension with established fibrillation, other things being equal. Quinidine therapy often reduces the frequency of, or abolishes, the paroxysms. AUTHOR.
Kunkel, Paul, and Stead, Eugene A., Jr.: Blood Flow and Vasomotor Reactions in the Foot in Health, in Arteriosclerosis, and in Thromboangiitis Obliterans. J. Clin.
Investigation
17:
715, 1938.
Measurements of the blood flow in the foot in health, in arteriosclerosis, and in thromboangiitis obliterans were made under standard conditions by the plethysThe flow was recorded as cubic centimeters of blood per mographie method. minute per 100 cc. of tissue. The blood flow to the foot reached a constant level after thirty minutes at 43” C. The flow at this temperature has been designated as the “maximal” flow. The average maximal blood flow to the foot in normal persons was 17.1 c.e., with the highest 25.9 and the lowest Il.1 C.C. Ninety per cent of the flows were