Hypertension studies in the Soviet Union.

Arterial hypertension control trials conducted during the last decade in the Soviet Union are reviewed. Epidemiologic data illustrating a considerable prevalence of arterial hypertension in various regions are presented. The results of population hypertension control programs are discussed, and the feasibility of reducing total mortality in the intervention vs reference groups at the community level is demonstrated, with the mortality and morbidity due to stroke showing a two-fold decrease. An outline is given of the major approaches used in population programs started in recent years, which are geared at improving drug and nondrug prevention and altering approaches to hypertension control in public health care.

Cerebral abnormalities in the Neu-Laxova syndrome.

Cerebral abnormalities are considered an obligatory manifestation of the Neu-Laxova syndrome and include lissencephaly, severe microcephaly, aplasia of the corpus callosum, hypoplasia of the cerebellum, and other pathological changes. We present data on 3 cases with central nervous system anomalies, two of which have not been described previously, and summarize the literature on the subject. The problem of distinguishing type III lissencephaly is discussed.

Partial trisomy 5q and partial monosomy 5q within the same family.

The observation of partial trisomy for 5q31-5qter and partial monosomy for the same segment in two offspring within the same family is presented. Their normal mother was a balanced carrier of a reciprocal translocation 46,XX,t(5;10) (q31.3;q26). The trisomic female had craniofacial dysplasia, a short neck, clinodactyly of the 5th fingers, a small umbilical hernia, arhinencephalia, cerebellar hypoplasia, atrial septal defect, an accessory spleen, bifid uterus and vagina, hypoplastic ovaries. Potter syndrome with cystic dysplasia of the left kidney and agenesis of the right, urethral atresia, uterus unicornus with utero-urethral fistula, true hermaphroditism with two ovaries and one testicle were found in her stillborn sister. Analysis of the manifestations of monosomy 5q and trisomy 5q in the same family supports a well known fact that the effects of deletions are more pronounced than those of duplications for the same segments.

Results of long-term propranolol treatment in myocardial infarction survivors with advanced grades of ventricular extrasystoles.

204 patients with established ischaemic heart disease, aged up to 62 years, were divided at random into two groups according to the matched pairs principle with respect to factors influencing long-term prognosis. Before randomization, the patients' ECG was monitored for 24 hrs, a treadmill exercise test and roentgencardiography were performed. The follow-up period was about 1.5 years. In the experimental group of 101 patients who were given propranolol in individualized doses (40-320 mg/day), which ensured a decrease in heart rate by 15-20%, sudden coronary death was significantly less frequent (p less than 0.01) than in the control group. The occurrence of repeated non-fatal myocardial infarction did not in the two groups significantly differ. A decrease in the occurrence of ventricular extrasystoles in the propranolol treated group was found only at the exercise test.

The Smith-Lemli-Opitz syndrome. A detailed pathological study as a clue to a etiological heterogeneity.

An analysis of 33 autopsied cases with the Smith-Lemli-Opitz syndrome (including 8 cases from our practice) is presented. Polydactyly in dead SLOS children was found in 51% (17/33) of cases and occurred significantly more often in this group than in the whole group of SLOS (20-22%). Certain morphological differences in the type of renal, cerebral, pulmonary and pancreatic anomalies indicate the existence of two phenotypically similar SLOS: 1) with polydactyly; 2) without it. The presented data initiate SLOS heterogeneity.

Detection of ischaemic heart disease by electrocardiography in clinical practice and in mass population studies. Comparative investigation.

Two groups of epidemiologists (in Moscow and Prague) and a group of clinicians in Moscow evaluated independently of each other 283 electrocardiograms. Comparison has shown considerable agreement in the views of epidemiologists of both groups, especially as regards evaluation of cicatricial changes in the myocardium and of ischaemic-type T-wave changes. Intra-group differences in the evaluation of ECG signs of IHD were among epidemiologists substantially smaller than among clinicians. ECG criteria of IHD signs, used by epidemiologists, have a higher specificity than clinical criteria but smaller sensitivity, which corresponds to the demands placed on cross-sectional mass population studies. Possibilities were further examined of using a computer for automated ECG analysis. Comparison of the evaluations of 388 ECGs by two specialists and a computer showed a high proportion of true positive findings of marked cicatricial (93.3%) and ischaemic-type (63.7-76.4%) changes in the myocardium, detected by a Siemens computer.

Prevalence of ischaemic heart disease, arterial hypertension and intermittent claudication, and distribution of risk factors among middle-aged men in Moscow and Berlin.

The initial examinations of prospective epidemiological studies of the same kind performed in random samples of 50-54 years old men from Moscow and Berlin showed the following prevalence rates (each first figure for Moscow, second for Berlin): ischaemic heart disease 14.4/13.6%, arterial hypertension 18.0/19.0%, intermittent claudication 6.9/3.4%, cigarette smoking 46.5/51.4%, overweight 22.9/21.9%, impaired glucose tolerance 36.6/42.5%. Hypercholesterolaemia (24.6/8.1%) was not comparable because different determination methods were used. In both population samples almost a half of IHD and 1/3-1/2 of hypertension cases were newly detected only by the study examinations. More than 80% of the 50-54 years old men showed the presence of one or more risk factors. The following significant relationships between disease groups and risk factors were found: for IHD, with hypertension, impaired glucose tolerance, and hypercholesterolaemia (Moscow only); for hypertension, with overweight, impaired glucose tolerance, and hypercholesterolaemia (Moscow only); for intermittent claudication, with cigarette smoking, impaired glucose tolerance, and hypercholesterolaemia (Moscow only). These comparative studies demonstrate the benefit and need of further common research and efforts for prevention and control of cardiovascular diseases.