Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1993 Feb 13;306(6875):437–440. doi: 10.1136/bmj.306.6875.437

Screen detected high blood pressure under 40: a general practice population followed up for 21 years.

J T Hart 1, C Edwards 1, M Hart 1, J Jones 1, M Jones 1, A Haines 1, G Watt 1
PMCID: PMC1676534  PMID: 8461729

Abstract

OBJECTIVE--To assess hypertension detected under 40 in a general practice population. DESIGN--Prospective case-control study. SETTING AND SUBJECTS--Former coal mining community in south Wales. Systematic case finding for hypertension and associated risk factors applied to a mean total population of 1945 from age 20 on a five year cycle through 21 years. Mean population aged 20-39, 227 men and 213 women. Case criteria: age < 40 and mean systolic pressure > or = 160 mm Hg or diastolic pressure > or = 100 mm Hg. Age and sex matched controls randomly sampled from the same population. MAIN OUTCOME MEASURES--Mean initial pressures and pressures at follow up in 1989 or preceding death, and all cardiovascular events. RESULTS--25 men and 16 women met criteria. Estimated five yearly inceptions were 26/1000 for men and 18/1000 for women. Male group mean initial blood pressure was 164/110 mm Hg for cases, falling to 148/89 mm Hg at follow up. Five male cases died at mean age 47.8, compared with two controls at 49.5. Female group mean initial pressure was 172/107 mm Hg for cases, falling to 145/86 mm Hg at follow up. One female case died aged 50, no controls. 10 male cases had non-fatal cardiovascular events at mean age 40.2, compared with two controls at mean age 50.5. Four female cases had non-fatal events at mean age 47.2, compared with one control aged 58. Male differences were statistically significant. CONCLUSIONS--Hypertension under 40 is dangerous, commoner in men than women, rarely secondary to classic causes, and may be controlled in general practice on a whole community basis.

Full text

PDF
437

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arkwright P. D., Beilin L. J., Rouse I., Armstrong B. K., Vandongen R. Effects of alcohol use and other aspects of lifestyle on blood pressure levels and prevalence of hypertension in a working population. Circulation. 1982 Jul;66(1):60–66. doi: 10.1161/01.cir.66.1.60. [DOI] [PubMed] [Google Scholar]
  2. Fowler G., Mant D. Health checks for adults. BMJ. 1990 May 19;300(6735):1318–1320. doi: 10.1136/bmj.300.6735.1318. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Hart J. T. Coronary heart disease prevention in primary care: seven lessons from three decades. Fam Pract. 1990 Dec;7(4):288–294. doi: 10.1093/fampra/7.4.288. [DOI] [PubMed] [Google Scholar]
  4. Hart J. T. General-practice workload, needs, and resources in the National Health Service. J R Coll Gen Pract. 1976 Dec;26(173):885–892. [PMC free article] [PubMed] [Google Scholar]
  5. Hart J. T. Semicontinuous screening of a whole community for hypertension. Lancet. 1970 Aug 1;2(7666):223–226. doi: 10.1016/s0140-6736(70)92582-1. [DOI] [PubMed] [Google Scholar]
  6. Hart J. T. The distribution of mortality from coronary heart disease in South Wales. J R Coll Gen Pract. 1970 May;19(94):258–268. [PMC free article] [PubMed] [Google Scholar]
  7. Hart J. T. The marriage of primary care and epidemiology: the Milroy lecture, 1974. J R Coll Physicians Lond. 1974 Jul;8(4):299–314. [PMC free article] [PubMed] [Google Scholar]
  8. Hart J. T., Thomas C., Gibbons B., Edwards C., Hart M., Jones J., Jones M., Walton P. Twenty five years of case finding and audit in a socially deprived community. BMJ. 1991 Jun 22;302(6791):1509–1513. doi: 10.1136/bmj.302.6791.1509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Heller R. F., Rose G. Current management of hypertension in general practice. Br Med J. 1977 Jun 4;1(6074):1442–1444. doi: 10.1136/bmj.1.6074.1442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kurji K. H., Haines A. P. Detection and management of hypertension in general practices in north west London. Br Med J (Clin Res Ed) 1984 Mar 24;288(6421):903–906. doi: 10.1136/bmj.288.6421.903. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Morrell D. C. Role of research in development of organisation and structure of general practice. BMJ. 1991 Jun 1;302(6788):1313–1316. doi: 10.1136/bmj.302.6788.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pill R., French J., Harding K., Stott N. Invitation to attend a health check in a general practice setting: comparison of attenders and non-attenders. J R Coll Gen Pract. 1988 Feb;38(307):53–56. [PMC free article] [PubMed] [Google Scholar]
  13. Pill R., Stott N. Invitation to attend a health check in a general practice setting: the views of a cohort of non-attenders. J R Coll Gen Pract. 1988 Feb;38(307):57–60. [PMC free article] [PubMed] [Google Scholar]
  14. Shaper A. G., Pocock S. J., Walker M., Cohen N. M., Wale C. J., Thomson A. G. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):179–186. doi: 10.1136/bmj.283.6285.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Smith W. C., Lee A. J., Crombie I. K., Tunstall-Pedoe H. Control of blood pressure in Scotland: the rule of halves. BMJ. 1990 Apr 14;300(6730):981–983. doi: 10.1136/bmj.300.6730.981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Thompson N. F. Inviting infrequent attenders to attend for a health check: costs and benefits. Br J Gen Pract. 1990 Jan;40(330):16–18. [PMC free article] [PubMed] [Google Scholar]
  17. Wadsworth M. E., Cripps H. A., Midwinter R. E., Colley J. R. Blood pressure in a national birth cohort at the age of 36 related to social and familial factors, smoking, and body mass. Br Med J (Clin Res Ed) 1985 Nov 30;291(6508):1534–1538. doi: 10.1136/bmj.291.6508.1534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Wallace R. B., Hoover J., Sandler D., Rifking B. M., Tyroler H. A. Altered plasma-lipids associated with oral contraceptive or oestrogen consumption. The Lipid Research Clinic Program. Lancet. 1977 Jul 2;2(8027):11–14. doi: 10.1016/s0140-6736(77)90005-8. [DOI] [PubMed] [Google Scholar]
  19. Waller D., Agass M., Mant D., Coulter A., Fuller A., Jones L. Health checks in general practice: another example of inverse care? BMJ. 1990 Apr 28;300(6732):1115–1118. doi: 10.1136/bmj.300.6732.1115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Zech P., Rifle G., Lindner A., Sassard J., Blanc-Brunat N., Traeger J. Malignant hypertension with irreversible renal failure due to oral contraceptives. Br Med J. 1975 Nov 8;4(5992):326–327. doi: 10.1136/bmj.4.5992.326-a. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES