高血圧の集団検診にかんする知見補遺 : 40才以上の男性警視庁職員6000名以上についておこなつた3年間の循環器検診成績
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概要
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This report is referred to the result of the screening test as to "High Blood Pressure", once a year, performed in more than 6000 men of police authorities above 40 years of age in the Metropolitan Police Board from 1956 to 1958. 55 cases (1 %) with newly discovered blood pressure elevation (B. P. EI.) at the exact examination performed after the screening in 1958 were found among those who showed the normotension at the screening in 1956 and 1957. 23 cases (10 %) with B. P. EI. at the exact examination in 1958 were found among 234 cases who showed the normotension at the screening in 1956 and B. P. EI. at that in 1957. 12 cases (9%) with B. P. EI. at the exact examination in 1958 were seen among 132 cases who showed the normotension in 1956 as well as in 1957. 9 cases (16 %) with B. P. EI. at the exact examination in 1958 were observed among 56 cases who showed B. P. EI. at the screening in 1956 and 1957, whereas disclosed the normotension at both exact examination. Even B. P. EI. at the repeated exact examinations, unquestionably the one at the screenings performed as above mentioned, contains more or less the casual high blood pressure in the sense of Prof. Smirk, so that it must be necessary to deliberate on Prof. Schroeder's or Prof. Pickering's definition about the arterial hypertension. Consequently the auther dared to use the term "Blood Pressure Elevation" instead of "Hypertension" or "High Blood Pressure". The distribution of each blood pressure level, the rate of the discovery of B. P. EI., the relationship between blood pressure and stature, subjective claims, apoplectic heredity, diets and so on were investigated about the results in 1956, 1957 and 1958. The rate of appearance of abnormal ecg. raphic findings taken at the exact examination in 1958 was 10 % in those who showed no B. P. EL in 1956 and 1957. However in the division with 160〜189 mmHg of systolic pressure (Sp.) or with 100〜119 mmHg of diastolic pressure (Dp.) it was counted up to 12 %, in the division with Sp. above 190 mmHg or with Dp. above 120 mmHg up to 33%. 57% of abnormal findings was the pathological deviation of ST-T, 21 % of them the various sorts of arrhythmia, and 15 % the right bundle branch block besides other kinds of conduction disturbance. The rate of appearance of abnormal ecg. raphic findings in 1958 was 14 % in those who showed previously B. P. EI. The rate of appearance of abnormal ecg. raphic findings in 1958 was 23 % in those who showed B. P. EI. at every exact examination of three years, but it was counted only up to 18% in those who did at that of two years, and it was more less found in those who disclosed newly B. P. EI. Among the group which had never shown B. P. EI. at the exact examination, no case with QRS duration above 0.10" was seen in the division with Sp. beyond 190 mmHg or with Dp. beyond 120 mmHg, except for the cases with bundle branch block. But among the group which had disclosed B. P. EI. more than once at the exact examination, the cases with QRS duration above 0.10" was counted up to 13%. Of the former group 1 % showed QT ratio less than 0.90, 19% that more than 1.10, whereas of the latter group nearly same % was found respectively, so that regarding QT ratio these could be seen no significant difference between these two groups. As far as QT ratio beyond 1.10 is concerned, those existed some tendency to increase in the rate of appearance of enlarged QT ratio as the advance of the age in both groups. The rate of occurrence of albuminuria was counted respectively up to 12, 12 and 14 % in the group with newly discovered B. P. EI. in 1958, in that with B. P. EI. the previous two examinations, and in that with B. P. EI. in these three examinations, so that there existed no significant difference between three groups. The retinal findings of both cases who showed newly B. P. EI. in 1957 and cases who disclosed B. P. EI. in 1956 & 1957 at the exact examination after the screening were investigated and classified according to Keith-Wagener's principle. In the former group the cases with intact retina or with K. W. I type were counted up to 71 %, while in the latter group the cases with K. W. II or III type up to 59%. In both groups rate of appearance of K. W. II or III type was larger in the division with Sp. above 190 mmHg or Dp. above 120 mmHg than in those divisions with blood pressure under these levels. The rate of appearance of the retinal findings was respectively 30, 37 and 53 % in the group with newly discovered B. P. EI., in those with B. P. EI. at the previous two examinations and with B. P. EI. at these three examinations, but it may be reserved to say whether a certain significance exists between the observation of the retinal findings among these three groups owing to the lack of the complete uniformity of case number in each group.
- 千葉大学の論文