僻地山村における診療所を中心とした高血圧管理の検討

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A programme had been under way for 4 years from 1960 to 1963 at Wago clinic in Anan Town, Shimoina County, Nagano Prefecture to study methods for the control of hypertension. The programme included about 430 inhabitants of Wago Community who are over 40 years. The method for the control of hypertension was based on mass examination of persons and examination of patients visiting the clinic in the clinic above-mentioned group. The following observation were made : 1. Much is expected of clinics in the control of hypertension in a community. If clinics were to take up a positive attitude toward the problem of management of hypertensives among the inhabitants, it would be possible to achieve excellent results in the control of hypertension both quantitatibely and qualitatively. The necessity is urgent for the establishment of a system for the control of diseases in which clinics are duly committed to performing proper functions. 2. An increase in the number of persons receiving physical checkup in mass examination, and the number of persons under medical care calls for a cooperative attitude on the part of clinics and better methods for examination. It is also important to stratify inhabitants and to take adequate measures to cope with stratification based on their conditions and natural and social conditions. 3. The incidence of hypertensives among persons over 40 years in the area under study, including persons whose maximum blood pressure was over 200 mmHg. or minimum blood pressure was over 120 mmHg. and persons whose conditions have become fixed with the maximum of 150 to 199mmHg. and with the minimum of 90 to 119mmHg., was 45.9%, while the incidence of persons with abnormal electrocardiographic findings was 42.5 %. The incidence of apoplexy, the mortality, and the presence of the disease per 1,000 inhabitants were 10, 9 and 30, respectively. The number of persons in the prime of life who succumbed to apoplexy was small. 4. It is necessary that persons at least over 30 years should be included in a programme for the control of hypertension. It is also necessary that a screening method based on the characteristics of individual groups or a screening method to be used when observation is carried out for a given period with the number of estimations varying with persons is established. 5. It is necessary to give priority to the management of persons with hypertension, persons with abnormal eleetroeardiographic findings and persons in advanced age who have a high mortality from apoplexy. In view of the fact that persons who neglect to received treatment and persons whose eleetroeardiographic findings are not established have a high incidence of apoplaxy, it is also necessary that proper measures are taken to take care of persons who are receiving insufficient management or left untreated.
千葉大学の論文
1965-03-28

僻地山村における診療所を中心とした高血圧管理の検討

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