Screen detected high blood pressure under 40: a general practice population followed up for 21 years.
OBJECTIVE
To assess hypertension detected under 40 in a general practice population.


METHODS
Prospective case-control study.


METHODS
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.


METHODS
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.
Hart
J T
JT
Epidemiology and Medical Care Unit, Northwick Park and Glyncorrwg Health Centre, West Glamorgan.
Edwards
C
C
Hart
M
M
Jones
J
J
Jones
M
M
Haines
A
A
Watt
G
G
D000328:Adult; D016022:Case-Control Studies; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008403:Mass Screening; D011446:Prospective Studies; D012307:Risk Factors; D014852:Wales / Q000453:epidemiology