Identifying borderline hypertensives: comparative value of various blood pressure measurements.

Ambulant male military aircrew patients (n = 299) were divided into two groups based on historic evidence of normotension (N) or of untreated borderline essential hypertension (BH). All patients had their blood pressure (BP) measured under various conditions and body positions. Results were analyzed to assess the capability of each BP measurement condition to assign patients correctly to their appropriate group. Clinical BP (physician-recorded with patient seated) and orthostatic stand BP (technician-recorded) showed best sensitivity and acceptable specificity. By incorporating the results of both these measurement conditions, a predictor approximating 90% for most BH and N patients was obtained. Use of these two measurements should enable recognition of most BH patients at a single evaluation.

A comparison of two bipolar exercise electrocardiographic leads to lead V5.

ST-segment depression and slope were compared in three lead systems (V5, CC5, and CM5) and in two groups of patients using both visual analysis of electrocardiographic paper and computerized techniques. Bipolar lead CC5 was found to be comparable to lead V5 when visual analysis of electrocardiographic recordings was utilized. Bipolar lead CM5 was found not to be comparable to lead V5 and to be less sensitive if classic criteria for slope were used. The technique of computerized analysis mad measurements of slope and amplitude to a reproducible level not possible with the standard technique. Statistically significant differences were found between the exercise electrocardiographic leads utilizing computerized electrocardiographic analysis . We conclude that computerized techniques of electrocardiographic analysis require new criteria for defining an abnormal repolarization response. The criteria must be specific for different electrocardiographic leads if the repolarization changes in these leads are to have comparable diagnostic significance.